Stage 1 Triangle of Care Gold Star!

The Triangle of Care submission to The Carers Trust  has been approved! In September 2016 we were awarded a gold star for completing Phase 1.

A group from the Trust presented their journey to build a carer friendly trust to the regional meeting held in Derby. This included a detailed report on how the Trust currently works with carers and our ambitions for the future. Really listening to carers and acting on what they say to improve our services means we can improve our partnerships and relationships. To do this we need to be prepared to co-produce more of our services together going into Stage 2 of The Triangle of Care.

64 self-assessments for 74 ward and crisis teams were part of the submission. Trust teams were asked to fill in a self-assessment saying what they are doing currently in their work with carers and to be candid on what they need to improve on.

 

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Head of Involvement – Paul Sanguinazzi sharing our journey with the Midlands Triangle of Care Regional Group, Kingsway,  Derby.

There was praise from The Carers Trust in how our staff are involving carers, the continuity and leadership of approach, plus the production of a Carers and Confidentiality Guide and carer awareness film for staff. They commented on how we were using Carer Feedback to improve services particularly via Patient Opinion  as being a valuable way to evidence our improvements.

The Carers  Federation  supported us every step of the way as our partner organisation for the submission..  Watch out for stage 2. The journey is not over yet…..

Special thanks to The Carers Strategy Group, Trevor Clower – Carer, Rob Gardiner – The Carers Federation and Trust Governor. Paul Sanguinazzi – Head of Involvement and all staff and carers who worked tirelessly to get us to this stage.

Jane Danforth –  Involvement & Experience Officer

Triangle of Care is Good to Go!

by Rachel Murnaghan Carer, Involvement Volunteer & Service User

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At the end of April  I spent a fantastic day at The Nottingham Involvement Centre with staff and carers across the Trust. It was an interesting collaboration and the purpose was to look at the self assessments forms which give a snapshot of where we are at the moment in our  work across the Trust and how our teams are involving carers, families and friends. The Triangle of Care approach was developed by carers and staff to improve carer involvement in inpatient and home treatment services as well as  giving examples of good practice. It recommends better partnership working between service users and their carers, and organisations.

There are six standards to achieve.

1) Carers are identified at first contact or as soon as possible.

2) Staff are ‘carer aware’ and trained in carer engagement strategies.

3) Policy and protocols re: confidentiality and sharing information, are in place.

4) Defined post(s) responsible for carers are in place.

5) A carer introduction to the service and staff is available, with a range of information across the care pathway.

6) A range of carer support services is available.

I really enjoyed the sharing of best practice and the good work done by our Trust teams to date. This boost for staff morale should encourage them into their future work with carers.

During the day I  heard about how teams such as the Crisis Team for CAMHS (Child & Adolescent Mental Health Services) and the gender clinic  are working with carers and their families.

We looked at some of the familiar themes coming up in the self assessments. Issues carers want to improve include support and communication with carers, lack of training for staff and how we need to share the news that we have Trust  Staff Carer Champions who are leading on how we work with carers.

More work is still needed on guidance around policies and what information staff  can share with carers. There is a new guide coming out soon about this. Sometimes it seems there is little support and compassion for carers and suitable signposting to other services.

Some carers like to use websites and they are a great idea to keep the information up to date but don’t forget those who can’t use technology. There are still issues for  our Trust staff knowing about who provides carers assessments and their information isn’t always up to date.

I just wanted to share a short part of what was a very busy day.  We have carers involved in the decision making processes and I felt really positive at the end. We have made a good start to  including carers, families and friends across the Trust

 

Hello, my name is Mike.

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Mike at the CPA Good Practice Awards

Hello, my name is Mike.  I’m a volunteer at  Rosewood Involvement Centre in Ollerton. I started attending two years ago, when I was caring for a close family member with depression.

As everyone who has been a carer will know, it can be a time to show people how much you love and care for them, but it can also have incredibly negative effects on your own well-being.  The loss of the person you once knew, the fading away of your social life and free time, the increased stress, anxiety and isolation… all this can have alarming consequences for your own physical and emotional health.

That’s why it is essential that carers can have quality time for themselves, where they can be just like anyone else. Rosewood was just such a place for me. When I began attending,  I was unsure what to expect. I was made to feel at home and it was not long before I was fully immersed in the world of Involvement.

Being able to see that there were other people just like me assuaged my sense of loneliness and isolation. Learning that there were others who suffered badly from mental health conditions and recovered to live a normal life gave me hope for the future. I began to attend every session I could.

Making friends and getting away from my caring role was not the only benefit of Involvement. I was able to access a number of training opportunities which greatly enriched my personal and professional development. This included  Involvement Interview Training which consisted of a course learning how to conduct an interview. Once trained, I participated in interviews for potential Trust employees as part of a patient/carer panel. You can learn a lot to use for your own future experiences as an interviewee!

I was able to attend Training sessions to ensure best practice in the workplace such as safeguarding children and vulnerable adults, equality & diversity, manual handling and back care, deaf awareness, and food hygiene and safety.

I have been given the opportunity to tell my story of caring to a number of audiences, including Trust staff members. This is very important to me since you are in a position to advise staff on what works well and what could be done better. Any opportunity to help shape attitudes and practice is vital. After this, I was able to participate in the Care Programme Approach (CPA) training, which involved delivering a presentation.

Training played a part in  finding a role I love where I can use my experience to help others. I began this role in August 2014. Around the same time, the person whom I cared for made a full recovery from their  illness. Recovery is an on-going process, but there has been no relapse and our lives have returned to normal; full of health and happiness.

However, I know that this is not always the outcome; for many people with mental ill-health. It is something they have to face on a daily basis and often for the rest of their lives. Their well-being is no less important than mine. That is the reason why I still volunteer; advocating the role of Involvement in ensuring best practice within the Trust.

I stood for the role of Public Governor in the 2015 elections. To my surprise and gratitude, I was elected for three years!  I’m looking forward to advocating my views, holding the leadership to account, and hopefully inspiring other people in my former position to see that, yes, things can get better. We must never stop working to better the lives of those with mental health issues, and those who care for them.

Carers Christmas fuddle Bassetlaw Hospital

The input of Carers, Families and Friends are vital to the work of the Involvement Team. Ingrid is an Involvement Volunteer and is regarded with great affection  as ‘The Rosewood Mum’ at The Rosewood Involvement Centre in Ollerton. She is a lady with a big heart  always thinking of others before herself. She has actively campaigned for carers to be included in all aspects of care and was responsible for the inclusion of a carers information leaflet for all carers and families with loved ones arriving for the first time on Bassetlaw Mental Health Wards. This was based on her own experience and what she wanted to know as a new carer arriving for the first time on a ward with a family member knowing absolutely nothing about Adult Mental Health Services. Ingrid is a member of  The Story Shop  and participates in many other volunteering activities. She is an invaluable member of the Involvement Volunteering team. Thank You Ingrid.

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Ingrid  AKA “Rosewood Mum”

Ingrid has written her thoughts on the Bassetlaw  Hospital Christmas event for carers.

”It was just fantastic! We had a very tasteful buffet , some carers had made their own dishes  which were delicious.

We had a mindfulness group for about 45mins which was really relaxing.

Then, to follow a harpist followed by the Rosewood Rockers (Vlas, Alan and Eric. So we had a good old sing song of favourites and some Christmas songs.

Rosewood Rockers
The Rosewood Rockers

All in all everybody really enjoyed themselves, a great afternoon.

Thank you to all who gave their time for us Carers, its much appreciated.”

INGRID🐤🐣🐓🐔🐥

 

Carers ‘Time to Talk’ is Working!

By Trevor Clower

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Carer & Involvement Volunteer

I wanted to share some of my work as a carer and Involvement Volunteer with you all. I am working with Tony Bernard, (Community Psychiatric Nurse) and Rene Custers, (Peer Support Worker), to pilot ‘Time to Talk’ project at Highbury Hospital, Bulwell, and Nottingham. Every Wednesday evening between 4pm & 6pm we are trying to get Time to Talk off the ground and make it known to everyone. This included carers and families as well as professionals.

Well, something I wanted to share with you was that I witnessed the kind of breakthrough that ‘Time to Talk’ is designed to do. Yes, we had two family members call in to talk about their son and discovered that although their son had been a patient for two years, they have never met his doctor in charge of his treatment, only letters and other official documents, informing them of the basics of their son’s treatment. After only two weeks of them contacting us at ‘Time to Talk’, in the family room at Highbury Hospital, we managed to get the doctor and the two family members together for a five-minute chat.

The five-minute chat lasted almost an hour with a very positive outcome. The doctor is now going to include the family in their son’s treatment plan, so they will be fully informed and not left in the dark, as they have for the past 2 years.

This is enabling the doctor to talk with the two family members directly at every opportunity, but also to prosper from the knowledge the two family members hold about the patient he is treating.

We have also opened the door towards Behavioural Family Therapy, to help them manage their lives and still be able to cope with the situation.

One down, just another 28, 999 to go, yes there are 29, 000 carers in the City of Nottingham, their needs is what Time to Talk is all about!

For more information please contact me via janedanforth@nottshc.nhs.uk and Jane will pass on my details or alternatively contact me via Twitter @Trevorclower

Who Takes Care of the Caretakers Daughter? By Michael Osborne

Michael Osborne

In this blog I want to discuss the role of the mental health patient, their carer and any staff of Nottinghamshire Healthcare Foundation Trust.

They will be called:

The patient. The carer. The clinician.

Please note that the term clinician may be a different person each time. The patient is taken care of at various times and places by the carer and the clinician.

Who should the patient care for?
They should take care of themselves as the first option. Often of course, they do not take care of themselves. It would solve many problems if they did especially for the carer and also the clinician and of course for themselves.

The patient should also take care of the carer.

This is part of the very emotional relationship between carer and patient. The carer/patient relationship can be challenging and this situation would be described and understood better by a patient and their carer.  However I will have a try!

The patient is often dependent on the carer but sometimes finds that very irksome and restrictive. The patient also can feel guilty about the physical and emotional strain they put on the carer. They do not want to be a burden. The patient is often more distressed by making the carer suffer.

Whilst the carer though loving the patient can feel anger at having their lives taken up by caring, this gives guilty feelings too. Often carers are angry with the illness and also with the clinicians for failing to find a cure.

Question: Should the patient help the clinician? (Discuss). I feel they should. When someone offers help either in friendship, physical care, advice or medication they should be helped and respected. However, the patient does not always want to be helped and may believe the treatment they are being offered is unhelpful. This can create conflict and distress to both.

But what happens when the carer joins this pairing?  Do they side with patient or the clinician?

The Carer frequently lacks information from either person to decide.  They end up with a double conflict of duty to the patient or their faith in the skills of the clinician.

All parties end up distressed and frustrated.

My proposal to improve the problems discussed in this blog is to increase communication and to encourage more of it; actually lots of it!

Communication between patient and carer I see as being very important with the same emphasis on carer and clinician whilst balancing this with the vital communication between patient and clinician.

The clinician may believe that the carer knows how to treat and take care of the patient. The clinician may believe that the patient knows how to treat and take care of the carer.

This is often not the case.

I believe a clinician should help and advise the carer in how to care for the patient.

I also believe a clinician should offer support and advise the patient how to care for the carer. (Discuss)

So often, the patient and carer don’t know whether to have faith in the clinician. Sometimes they get different perspectives from different clinicians.

Friendly, informal meetings should be the norm between patient, carer and clinician. They should all agree to discuss how to treat each other, how to care for each other and of course discuss the medical care together. Friendly communication can resolve a lot of problems.

Do not underestimate the power of the spoken word. Use it frequently and well.

Michael Osborne is a service user and volunteer with years of experience as a well respected member and champion of involvement within our NHS Trust.  Michael is generous with his time and always listens to others who may need support, often putting others needs before his own.

Michael is a passionate and keen advocate of open dialogue and invites you to a discussion. Please share and comment on his blog article.

County Carers’ group launched

Rosewood Involvement Centre Carer Volunteers, The Newark Community Rehabilitation Team and The Family Intervention Team have worked in partnership to establish a new County Carers’ Support Group; an initial meeting was held in April 15 which was very well attended and ideas and suggestions were all noted with regard to the purpose and aims of the group. It was decided that the meetings would consist of opportunities for involvement work, information about resources available to carers, and support, to be shared. The carers felt strongly that the meetings should be a place where they could problem solve together and have laughter and enjoyment.

ROSIE'S 2.7.15 action shot

The first meeting took place on the 2nd July 2015. The members all voted on a selection of suggested names for the group, the final choice being ROSIES- Resources Opportunities Support Information Enjoyment for Supporters.

Following requests from the carer members Michael Sergeant, Local Service Lead for Mental Health Act and Mental Capacity Act kindly gave a presentation regarding these topics in partnership with Amy Simmons, Clinical Lead from the Newark Community Rehabilitation Team. This was extremely well received and many positive comments from Carers were expressed: “we need more sessions like this”, “so very informative and interesting, I have learnt so much that is relevant to me”, “thank you and a superb session”. Amy Simmons stated “this is such an important part of my work and I am so pleased to be involved”.

For more information about ROSIES please contact Nigel Groves nigel.groves@nottshc.nhs.uk or telephone on 01159560845 or Amy Simmons amy.simmons@nottshc.nsh.uk or telephone 01158542216 or come along to the next meeting which will be on Thursday 1st October 2015 at 1.00pm, at Rosewood the Involvement Centre, Ollerton. The meeting is two hours long and you will be guaranteed a warm welcome and refreshments. Adele Bryan, General Manger from Adult Mental Health Directorate will be joining us in October as a guest speaker.

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