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

Posts tagged ‘CPA’

Mediaclip for staff training – participants wanted

Do you currently receive community services from LYPFT, or have in the last 12 months? Are you a carer of someone accessing LYPFT community services?

If so, and your care is arranged through Care Programme Approach, by sharing your story and experiences digitally you can help improve services through helping us understand what we do well, and where we can improve. Your experience would be used for staff training and for general mental health and carer awareness across the Trust and with the general public.video1-

Areas to understand include: assessment; care coordination; care planning; review; working with others including carers. Also your understanding of recovery and wellbeing.

Digital recording will be on the 17th and 20th of November, it will take no longer than two hours. If you would like to participate or would like more information then please contact Donna Kemp donna.kemp@nhs.net 07985259082

Thank you!inkwell nov

 

What are your top 3 messages for people planning your care?

What are your top 3 ‘makes a difference’ messages you would give to the people planning and providing your care, support and treatment?

I am keen to include the ‘individuals’ voice’ in training. Why? Because what’s the point in providing training if it doesn’t make a difference to the people accessing services. Training can become a standards checklist unless it relates directly to people’s care support and treatment in a meaningful way. The training has to resonate with the participant on some level if it is to have an impact and influence or change practice. The training has to have some value.

listening

In the NHS we are super keen to measure everything, and it’s not that I am against this; it’s just that the measurable bits are often ‘hard’ – concrete and tangible, but it might be that the ‘soft’ bits are where the quality sits. So for example, with Care Programme Approach, one of the standards is that everyone should have a review at least once a year. This is a ‘hard’ standard; it is a distinct event with a time-frame; it is one that is ‘counted’ and reported on. The quality or ‘soft’ aspect in this standard is harder to count but impacts on the persons experience of care support and treatment – the review should include the person’s views, should be held in a way that the person prefers, the review should be held when needed (a year is a long time when you want to be moving forward……) and the review might be a series of discussions and information gathering to inform the care plan rather than a formal, chaired event. It tends to be the ‘hard’ bits that drive practice. My concern here is that practice gets distilled down to the hard bits and the soft bits fall by the wayside. Don’t get me wrong, often it’s the hard bits that get the job done #performance, but is it at the expense of the soft bits #experience? Perhaps a blend of both is best, but have we got the balance right?

So, what are your top 3 ‘makes a difference’ messages you would give to the people planning and providing your care, support and treatment?

Write your own care plan

Guest Post by Maria

I was recently at a SUN meeting where I was fortunate to hear a lady speak about writing her own care plan; I found this heartening and was delighted when our paths crossed again thanks to social media. Maria agreed to write about her experience of writing her care plan and the effects it has had. She is keen to share her experience and hopes it will help other people……..

How did it come about?

Maria loneliness

By Maria

I had just come out of a really dark and difficult period and was trying to move forward the best I could. My CPN (community psychiatric nurse) and I were talking about my care plan and how ineffective it had been through this time. I expressed my frustration and annoyance at past care plans and how I’d never found them helpful as they were often filled with others perceptions of me, their interpretation of what my life needed, what my goals should be and their beliefs in what would be helpful in my  crisis. Non of them were true reflections of me or what I’d find helpful.

So my CPN handed me a template care plan and said I could read it through and write as much as I’d like, the things I feel should be or want to be mentioned and what I felt would benefit me in crisis. We agreed I would do what I could and she would edit, add to and finish off.

After reading through I found myself excited at the prospect of answering the questions posed. With only recently coming out of a crisis I was able to draw on that experience and what I’d found useful/helpful.

I soon found myself writing each section, my history, my aims, goals long and short term, a true description of myself and my life. What I believed to be my difficulties and how best to deal with them.

I wrote my crisis plan like never before with real difficulties and a realistic approach for all.

To my astonishment my CPN read it and didn’t change a thing.

What difference has it made?

It gave me a massive sense of control and the strength I needed to stand up and say “I can do this, it’s in my hands.”  It was a significant turning point for me were I realised my recovery was up to me and no one else. That services were there to support me whilst I worked on making changes to improve my life and manage myself.

Writing my care plan challenged me to really look inwards and think about myself. To really think about what I found difficult and what I think will help. It also made me think of the things I would like to happen and goals I could obtain. It gave me a glimmer of hope that recovery was a possibility.

My Care plan was now something that gave me an aim, a clear focus on the areas I needed to work on to achieve the things I wanted for myself.  It also made me more aware of the  behaviours and patterns I’d established that were unhelpful and the things I could do to help me manage my day to day life.

The most significant  area I’ve truly benefited from is my crisis plan which is more fitting to my personal needs and how i react in crisis. I wrote it stage by stage and what to do to help me depending on the depths of my despair. I believe it was most helpful to myself because in crisis I’m no longer “rational” me and I find it incredibly difficult to trust anyone, therefore I could read it and trust what it said as it was my rational self who’d written it. This made it easier to accept and follow making the really difficult times shorter in length and better managed.

What key message would you give to other people about writing care plans?

Maria quote 1Service users have to be involved in their care plan. A CPN and service user need to work together  to collaborate a care plan that’s a true reflection of the service user with realistic  goals, expectations and what’s effective short and long term, crisis or not.

Services need to trust and understand that we know ourselves better than anyone, therefore ask us what’s helpful and unhelpful. Ask us what we want to change, ask us what our recovery looks like because we know better than anyone.

Service users need to take charge of their recovery and accept the professionals role. Services are there to help, support and understand as much as possible but can not nor will not make you better. Only you can can make recovery happen with the right support, so let your care plan be the start.

 

 

Service User Experience of CPA Reviews – final report

People receiving care, support and treatment from Leeds and York Partnerships Foundation Trust (LYPFT) should have a care plan and this should be reviewed regularly. Care may be arranged through ‘Care Programme Approach (CPA)’  or through ‘Standard Care Plan’ if needs are more straightforward.

LYPFT sent out a brief questionnaire to people on CPA to find out what their experience of their review was; you can read a bit more about the questionnaire here.

The results from the questionnaire, the full report can be found here:final report

  • People being offered or given a copy of their care plan was 54.5%.
  • Understanding what is in the care plan, being involved in agreeing the goals and being aware that other people could be involved in the review are areas identified for improvement.
  • Areas where the results should be celebrated are that people are aware of who their care coordinator is, that they were asked how they were feeling, that they had their say and that they found the review overall helpful.
  • Results from 2013 to 2014 are overall improving.
  •  The response rate to the questionnaire was lower than anticipated at just over 7%.

In response to the questionnaire results LYPFT are focusing training on improving service user involvement in planning care. There are monthly awareness sessions across Leeds and York – dates for these are available here; they are open to people accessing services and carers as well as members of staff across LYPFT and partner organisations. The Planning Care Workplan Implementation Group are tasked with overseeing LYPFT activity in relation to planning care – you can find out more about this group here.

Many thanks to those of you who participated in completing the questionnaires.

Donna Kemp | CPA Development Manager

 

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Planning Care: Awareness Sessions

training sessions

 

 

 

Planning Care Checklist

Planning Care Checklist

Join the conversation here.

Planning Care in Assertive Outreach

I was fortunate enough to spend some time with Leeds Assertive Outreach Team (AOT) this week.  Assertive Outreach teams have been around for some time and are intended to support people with severe mental health difficulties who find it difficult to work with traditional services. You can read more about AOT’s in this Rethink information leaflet.

I initially met with AOT late last year to hear about how they were using Care Programme Approach (CPA) to co-ordinate, plan and review care. There were 3 questions considered:

1. How does CPA works within Assertive Outreach?

Around care plans it was identified that most people did not want a copy of their care plan; that reviews held varied interest to the service user – from ‘something to be endured’ to ‘very keen’.  In response to this the coordinators use a number of flexible methods to complete the review.  Where the person is in hospital the coordinators take the opportunity to spend time with the person developing the care plan for when they are discharged; it was acknowledged that the in-patient CPA review was not always conducive to agreeing goals and detailed plans following discharge. There was some variation in the way the CPA documentation was completed.

2. Why does CPA works within Assertive Outreach?

The team reflected that their ability to be flexible contributed to CPA working well within the team, factors impacting this were their level of experience, good understanding of care management/planning and proactive engagement with people using the service and partner agencies.  Capacity was also identified as a factor, that coordinators have around 12 people on their caseload.

3. What could be better?

  • Inpatient reviews being held more flexibly
  • Summary – a one page summary would be useful alongside the full care plan; it would also capture initial plans.
  • Documentation – The running order of the CPA Care Plan could be improved; the language could be simpler; the review questions should be revised.

The full report is available here.

Having met with AOT again this week, it is apparent that they continue to use CPA well to provide co-ordination, care planning and reviews.  The coordinators find a way to involve the person in planning their care despite on the face of it the person not necessarily wanting to be involved.  The involvement comes through negotiation, flexibility, working with the persons priorities first and through getting to know the person, and their carer(s)/networks/supporters well.

Of the CPA documentation, there are changes planned following a review of what we have and feedback from service users, carers and clinicians.  You can read about the changes in full here; but the headlines are:

  • CPA Care Plan name changing to My Wellbeing & Recovery Plan
  • Change in wording used for the care plan headings – to be straightforward, plain English
  • Goal setting and care planning section made simpler
  • Additionally,  a ‘one page care plan’ to be included within the Integrated Care Pathway trial

How does CPA work in your team?

What would make CPA better?

If you access services or are a carer: What is your experience of  being involved in developing your care plan and in your review?

If you have recently had a review, then you should receive a brief questionnaire through the post, alternatively, you can complete this online here.

 

 

 

 

 

Information for people accessing services and carers about CPA


cpa-logo

Care Programme Approach (CPA) is the term used to describe the way that a person’s care, support and treatment is arranged when they have a range of needs.  This is done through assessment, coordination, care planning and review.  Some people will have straightforward needs; their care, support and treatment are described as ‘Standard Care Plan’.  You can read our policy: The Trust Wide Care Programme Approach Policy (including arrangements for Standard Care Plan) here.

Information for people accessing services and carers about CPA

1735_DSC_0245_scrabble_recoveryThe single most important thing about CPA is that you should be at the centre; it’s about you; it’s about what you want to do with your life; about what you want to achieve and how you want to achieve it. This may involve support, care and treatment from others – people that support you, carers, your friends, family, it may also include mental health services, health services, social care, and other organisations near where you live. Some people also get support from others going through similar difficulties – this is often called ‘Peer Support’. You can access peer support in a number of ways, for example, Mind, local groups or online support.

 

There are four stages to CPA:-

1. Assessment
You will be asked questions about aspects of your life and past, for example: personal; health; social;  about your safety (this is sometimes called risk); about what you enjoy doing; about what you do to help manage; about anyone else all ready involved in your care and support, including any carer. Carers can have their own assessment.

 2. Care Coordination

A care coordinator will be named to work closely with you and your carer to arrange care and support and to work with you to agree goals.
3. Care Plan
This describes your health and social care goals.  The care plan says which services will help with recovery and wellbeing; and what you do to help too.

The care plan is about you. It is developed with you and includes your goals; what support is being offered; who is giving the support and when the support will be reviewed.  The carer will be included too if you want this.

You may write the care plan yourself, or write it with your co-ordinator, either way, you should have a copy of your care plan.

4. Review
These are sometimes called CPA meetings; they happen at least every 12 months but can be more often. This is where the care plan is reviewed.  This is done by discussing with you, your carer (with agreement) and any others involved in your care plan about what is working well and what may need to be changed to support your recovery and wellbeing. The review is usually held in a way that you prefer – for example, some people prefer more of a relaxed discussion with their co-ordinator, others prefer a full meeting with everyone involved present.

Have you recently had a review? If so, let us know how this was for you by completing a brief survey (12 questions) – click here for more information and the survey. Results tell us what we are doing well and where we need to improve.


Standard Care Plan

If you have straightforward needs and are seen by one mental health worker then your care, support and treatment is described as ‘Standard Care Plan’.

You can expect:

  • A lead professional identified – this will be the person that you see
  • A letter – this is the care plan
  • Review – this is a chance to talk about how things are going and any further care plan agreed.

More written information

Click here for an information leaflet about CPA

Click here to read an information booklet on CPA – for people in Leeds

Click here to read an information booklet on CPA – for people in York and North York

These booklets are also available in Urdu, Farsi, Czech and Polish – contact donna.kemp@nhs.net for these.

Want to get involved and keep up to date about what’s going on?

blog title jpegThe LYPFT Planning Care Network is a digital space for people who access services, carers/supporters, staff and partner agencies to share their ideas and experiences around care coordination and care planning.  Click here to visit the network; you are most welcome to post comments and to share your views and experience. If you want to write your own blog post, then contact donna.kemp@nhs.net to discuss.

SUN logoYou can also join the Service User Network – they meet monthly in a range of venues across Leeds; click here for more information.

 

If you require any further information regarding CPA or Standard Care Plan then please contact donna.kemp@nhs.net

LYPFT Trust Wide Care Programme Approach Policy

The Trust Wide Care Programme Approach Policy (including arrangements for Standard Care Plan) has now been published at Leeds and York Partnership NHS Foundation Trust following a review of the outgoing CPA Policy; it identifies best practice as outlined by the Department of Health, Nice Guidance and the various frameworks supporting practice. There was consultation across Leeds and York – clinical groups, service user and carer groups, social care and partner agencies.

Of note, the following are included within the policy:

  • The term ‘Standard Care Plan’ will be used to describe the arrangements for people not on CPA (this replaces the term ‘care plan’)
  • Involving people in developing their Care Plan and writing the care plan in a way to reflect this
  • The person (and their carer if agreed) should be provided with a copy of their Care Plan
  • Agreeing with the individual the best way to arrange their ‘Review’ – CPA or Standard Care Plan
  • Guidelines for Section 117 Aftercare including template for discharge or transfer – these have been agreed across the local authorities in Leeds, York and North Yorkshire

You can find a copy of The Trust Wide Care Programme Approach Policy (including arrangements for Standard Care Plan)  here.

The policy will be reviewed again in 2016, work on that will start in the next 9 -12 months. In the meantime, please feel free to leave your comments or feedback, they will be considered in the review. Nearer the time, I will be asking for people to express interest in getting involved with the review……..

Donna Kemp | CPA Development Manager | donna.kemp@nhs.net

 

 

 

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Pathways to Recovery: Service User & Carer led research, a carers view

Service User Led Research ‘Is there a pathway to recovery through care coordination?’ was presented at a recent CPAA event  – click here to read more about this event. This emancipatory research was designed and conducted by people with lived experience of mental health difficulties and carers.

This research supports recovery in a number of ways – for example, personal recovery and wellbeing; hope, inspiration and aspiration for others; contributing to the evidence base for recovery. This is a positive story that should be shared…… Caroline Kemp (no relation 🙂 ) agreed to write about her experience as a carer & researcher; and shares a poem about coding…….

Pathways to Recovery..how and why I got involved..

The last few years have been very rewarding for me…the path has been very stimulating and has been a big learning curve.

My background has been in mental health as I have cared for my daughter for over 16 years. She has enduring and severe mental health problems..her path has been very tough and witnessing this battle is also equally as tough..too much anxiety and panic. .and also the fact that no meds seemed to be of any help..just lots of dreadful side effects…as a mum and a Carer you expect or try to fix things..I always thought things would be better if only we could find the right meds…I tried to read as much as I could so I could help..I thought in the early days I would fix it..and my daughter would not suffer needlessly for years…

When I first heard of the research into pathways to recovery through care coordination I felt strongly I wanted to be a part in it..( I had had plenty of experience of Care Coordination..not all positive ) The reasons were mixed..on one hand they were purely selfish..if there was any hope of finding recovery I had to know it.. I wanted to have some hope…the other reason was to make things better for everyone in anguish and torment..I think this is also why people do research in the first place..to make things better.. I had seen too many people abandoned on the acute wards without a single visitor.  Also our research group were chosen because of their expertise and life experience..there was no formal academic requirement..another strength was we were a mix of service users, Carers and professionals.  We had multiple perspectives and this made out research even better science. Also I knew from the way this research was done we would play a full part in doing it..at all levels ..it would not be a tick box exercise.

C Kemp poem

At Northumbria we were given excellent training on research up to PhD level ..so this gave our group the confidence to do all the interviews..Carers  interviewing Carers and S U interviewing S U…in all the interviews this has made a difference to our data as people related to us and disclosed more of their true feelings..perhaps this was because we had shared journeys and paths. We developed questionnaires, piloted them, and refined them.

After hearing all these stories I cannot help being amazed at human resilience in the face of terrible tough times and challenges..

Not only did we interview but we also did data analysis ..I never thought I would be able to do this but after all our training I had the confidence to sign up for it..it certainly sharpened our interviewing skills and kept us on task on answering the research project question..not just collecting hours of data. I also learned a whole new vocabulary …Nvivo and nodes…parent ones too..

I have been part of this research for over three years now and I have had many highlights..

What I loved was meeting every Wednesday and analysing the data; keeping a reflective diary and writing poems around recovery..I have been published in an American journal; doing many Carer interviews and sharing people’s life stories; being asked to present at conferences, INVOLVE and to the Trust; talking to students at Northumbria on our research; I also did a short video diary for NIHR ( National Institute of Health Research ) this has been used to train students too; and have been interviewed twice on the radio! At the INVOLVE conference our group was selected to be in a film also. It has been very exciting. We have been brave enough to step outside of our comfort zone.. And it has been well worth it. It has been part of our recovery too..that is being engaged in something meaningful and the added bonus of being for the benefit of others.

Caroline kemp

Presenting at St James

At the moment we are preparing our next three conferences on the findings to the trust and developing a toolkit. Also we have been asked to write about our journey and how we did it..not only academic papers but also a book..so we have a lot to do.

But this is how I like it and I think I speak for others in the group too..we will be sad when it ends..however I think when you do become involved it always leads to many other things..jobs for some, enhanced skills..now we are a trained group of researchers and can offer our own training and experience to others…

I am glad I have been valued as a Carer and service users in the group are also glad that their mental health experiences have been recognised and valued and able to be of benefit to others on the pathway to recovery.

It gave me hope things could be different and I would encourage everyone to become involved in research ..you do not have to have a degree..just valuable life experience. And empathy ..and a willingness to work and share together and learn from each other. It was great being part of a team.

Caroline Kemp

Choice & how people want to be treated: key messages from SUN

SUN logo

At the March Service User Network (SUN) meeting there was a discussion carried forward from the previous meeting. The SUN members wanted to explore areas that they would like choice in. The following two questions were addressed at tabletop discussions, and the responses are condensed:

1. What would you like choice in?

  • Which service I am involved with
  • Choice of worker and who I work with – gender, CPN/Support worker/care coordinator, access to different professions, seeing the same worker
  • Appointments – flexibility in where we meet
  • Involvement in planning care – reviews: how often, who attends, what is discussed; involved in agreeing care plans;
  • Medication – the different options, including not taking any medication, easy access to a second opinion
  • Treatment and therapy options – CBT, DBT, TC; what we do not want and what we do want, including ECT; access to complementary therapies; mindfulness
  • Access to peer support – including courses (Mind), easy access
  • Personal independence budgets
  • Where I live and the things I do – like cooking, what I eat, and watching sport
  • To have the right to make my own choices

2. How would you like to be treated as an individual within Mental Health and Learning Disability services?

  • Treated as a person, not an illness
  • As an equal – regardless of my characteristics
  • Non-judgementally – with respect, compassion and understanding
  • As an intelligent person – just because I have a mental health problem doesn’t mean I’m stupid – people can talk down to you!
  • As an expert in my own issues and life
  • As a customer – eye contact, honesty, humane, respect my sense of urgency in crisis
  • To be talked to, listened to and liked – to be seen as worth getting to know and be with
  • That my feedback is accepted – that what I say has value

These points will be discussed at the April SUN meeting and next steps in moving this forward decided. How would you like to see this – as a charter? a ‘best practice’ support? All ideas welcomed!

What is your view from a mental health professional, carer or partner agency  perpective? Feel free to comment…..

Please leave a comment if you have anything to add to these suggestions…….

The next SUN meeting is on Wednesday 2nd April at St Chad’s Community Hall in Headingley; the guest speaker will be Dr Jim Isherwood, LYPFT’s Medical Director – click here to see the flyer. All are welcome to attend, but if you can’t get there, please feel free to post any comments or questions you may have for him here or email donna.kemp@nhs.net

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Using data to improve care – a participation event

LYPFT Planning Care Network – our first event of 2014!

You are invited to join us in a participation event that brings together service users, carers, health and social care practitioners alongside developers, designers and coders to explore using data to improve care.

Click here for full details of the event and the issues we are hoping to explore.

The event will take place on Friday 11 April 2014 between 10.00 – 16.00.

Time: 10am until 4pm
Location: Arthington House (part of Leeds Federated Housing),
30 Westfield Road, Leeds, LS3 1DE

We will provide lunch and refreshments during the course of the day.

To book your place and let us know if you have any specific requirements please contact Susan Portland by 31 March 2014: Email: s.portland@nhs.net or telephone: 0113 30 55972

Please note: for those eligible, reimbursement of travel expenses will be made on the day (receipt needed). If you have any questions or comments please contact donna.kemp@nhs.net

Care Programme Approach – a national perspective

I was asked by @WeMHnurses to get involved in hosting a Twitter Chat about Care Programme Approach (CPA). I agreed (with a fair bit of persuasion as I am quite new to Twitter) and the chat took place on March 10th.  You can read the Tweets here ; and view the background information here.

twitter

One of the great things about getting involved in discussions on Twitter is the broad range of perspectives that are brought together from across the country in one place, in real-time.  It’s great for provoking thought and an appreciation of views that might be contrary or complementary to your own.  Though a social media platform, Twitter is far more than social, it is a place to ‘meet’ other professionals and experts by experience; often those that you would not usually encounter in your day-to-day working life. Mark Brown talks about ‘Public Professionals’ a unique perspective of how health care professionals connect with the wider community, definitely worth a read (here)  if you ever wondered about the value of participating in social media.

Back to the national perspective contributed at the Twitter Chat; here are some of the key points that came up (and some of my thoughts in italics):

 

  • CPA is an odd name, not very descriptive of what it is. Some folk refer to it as ‘the CPA’ but not clear on what this is referring to – the assessment, the care plan or the review? Perhaps this reflects a lack of understanding or perhaps a culture within the clinical area – does this matter or is it a pedantic point of a CPA geek (me)?
  • Documentation – completion of it seems to be a task ‘ paperwork to be filled in’ rather than a collaboration;  can be a useful tool when used properly.  Need to consider the individual’s experience of how we approach CPA – if we see it as form filling, then that is how it is likely to be perceived. What support do staff need in ‘reframing’ their view of CPA?
  • Variable take up across UK; an effective approach but only when it is implemented properly, difficult with the current fall in resources and increase in demand – all folk receiving ongoing care support or treatment should be either on CPA or ‘Standard Care Plan’
  • People need the right information about CPA; this information is not always available – I am assuming that some organisations are not providing written information for people accessing services, Department of Health did produce some literature, but it is quite a while ago. Is what we have in LYPFT ok?
  • CPA should be aligned closely to recovery/wellbeing/personalisation and not seen as separate; and owned by the person; carers and family should be included.  Fully agree, some very good examples of this in practice, if folk use recovery ‘principles’ in the way they work, then CPA is approached in the same way.

How does this fit with your experience of CPA across Leeds and York? It would be great to hear how CPA is being used in different teams.

 

CPA – are we there yet?

I was asked by @@WeMHnurses to get involved in hosting a Twitter Chat about CPA. I agreed (with a fair bit of persuasion as I am quite new to Twitter).  You can read the blurb here or read on for a bit of background to inform the Twitter Chat; please do join in, it’s on Monday 10th March at 8pm.

Care Programme Approach (CPA) has been around since 1990 and is an umbrella term to describe the way that a person’s care, support and treatment are arranged in secondary/specialist mental health services through: 

  1. Assessment
  2. Coordination
  3. Care planning
  4. Review

Who should be ‘on CPA’?

Refocusing the Care Programme Approach – policy and positive practice guidance (DH 2008) sought to provide clearer guidance on the characteristics of those needing the support of the CPA framework (see p.13).

In addition, individuals within the following groups should be supported by CPA unless their assessment shows otherwise:

•  Individuals who have parenting responsibilities

•  Individuals who have significant caring responsibilities

•  Individuals with a dual diagnosis (substance use)

•  Individuals with a history of violence or self harm

•  Individuals who are in unsettled accommodation

Some people don’t need CPA but they should still have a care plan (can be a letter), a named lead professional and a review.

To summarise, the CPA framework in place; it considers those that do and those that don’t need CPA; it’s not new; it aligns with the way that different professions work (eg. nursing process); the value base is linked to the Ten Essential Shared Capabilities (2005).

So why, over 20 years later, do I wonder “are we there yet?”

The constantly changing mental health landscape necessitates us to reflect upon what we are doing and to ‘check’ that everything still fits. For example, the introduction of integrated care pathways (ICP’s) –  does this fit with a person centred, co-produced care plan? So the ‘are we there yet?’ question continues to arise but the reality is that the destination is not within our grasp, we get ‘rerouted’ when we think our destination is near. But this is ok; in our professional lives the constant is change. Here are some of the ‘reroutes’ to ponder in relation to planning care: 

•  CPA is linked in with performance reporting with Monitor and Mental Health Minimum Data Set informatics requirement and is included in the National Service User Survey ; results/reports from these tell us that there is a disconnect between the information that organisations hold and what people that access the services tell us about their experiences. How can these differences be explained? Do people who use services and carers/supporters know about CPA? Does it make any difference?

•  Personalisation and Recovery/Wellbeing are approaches that are prominent in mental health. How do these approaches work alongside CPA? Are we finding any conflicts and if so, how are we working through these?

•  How do we ensure that the person is at the centre of their care, support and treatment and that care plans are co-produced?

•  And of course, the question of austerity – how have the NHS cost savings impacted on how we provide CPA? How are mental health professionals maintaining quality?

Share your views/experience

There is a digital conversation guest hosted by @donnajkemp planned for Monday 10th March at 8pm on Twitter to discuss these points; do join us at #WeMHNs;  alternatively post your comments on here.

Click here for more info about the ‘Twitter Chat’ and for links on how to use Twitter

@WeMHnurses is part of the @WeNurses community and is curated by @mrsgracepoole and @NatalieMHN

Exit comfort zone stage left…….

That is how it felt when the plan for CPA – making a difference  got the green light and was signed off. CPA - making a differenceThe plan focuses on listening. Listening to what people say about Planning Care – from people’s personal experience of accessing care, support and treatment across LYPFT services  to hearing how people would like services designed and delivered. Listening to what staff say about what they need to provide the best care, support and treatment and listening to what our partner agencies, statutory and third sector, say about what its like being alongside LYPFT.

Listening is a key element of communication, the listening part is key to understanding different viewpoints and identifying people’s priorities; and it is around here that I start to leave my comfort zone. The tension emerges when there are differences between what people want – from differences between individuals to differences between different groups or ‘stakeholders’.  Difference is good, it would be rather dull if everyone wanted the same thing but how to reach consensus fairly? The end result will be some folk are delighted, some are dismayed. My challenge is to remain neutral enough to ensure that people can freely express their views but to provide enough information for people to consider their views upon.  At times there can be different priorities between people who access our services, the professionals delivering the service and the organisation itself; final decisions are often made at quite a distance from where the original discussions took place, it takes courage to shout up for other people’s views and it requires committment and believe  to progress what can initially appear as disparate agendas (though they often are not).

So why am I sharing this? Well, hearing people’s views and making shared decisions is what we all do.  Discussions with staff across the organisation be it face to face, via email or social media constantly reminds me that we are all working in a similar way. I wanted to acknowledge this and share a bit about how this shift has changed the way I work and some of the challenges this has brought along the way.

If you are still reading, then you will be aware that I didn’t manage to squeeze in competence and compassion – oh look, I have now! So what’s all this about? 6CsWell, it’s about building Compassion in Practice;  you can read more about this, along with examples of how this is working locally here,  you can also read here about how Towngate House Rehabilitation and Recovery Team are building a culture of compassion.  So how are you building compassion in  your practice?  If  you access services or are a carer, how do you experience compassion in care – is this something that can be felt/experienced? How does it make a difference?

So whats the link between The 6Cs, Planning Care and exiting comfort zone stage left? Well if we apply the culture of compassionate care to the way that we work with people in planning care then the benefits to people who access our services and their carers should be evident. I came across The 6C’s on Twitter. Yes Twitter. Something very new to me and a steep learning curve in many respects. I had not underestimated the value of twitter in relation to connecting with people professionally, with the public and people in other organisations, fact is I had not estimated it at all. But that’s a whole other subject…….

Thanks for reading – Donna Kemp

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