Triangle of Care is Good to Go!

by Rachel Murnaghan Carer, Involvement Volunteer & Service User

IMG_1235

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

 

Involving the Involvement Centres in Research!

It was an honour to be guest speaker at the Involvement Centre at Duncan Macmillan House and the Rosewood Involvement Centre. I was joined by my colleague Dr Oonagh Meade. On both occasions I presented some of the findings from my recently published paper on service user perspectives on mental health care planning [1].

As a service user myself, working on a care planning programme of research it was reassuring to be welcomed so warmly and to share what we’ve been up to!

The Involvement Centres have been influential in publicising our research studies and took part in an interview study asking for service user’s experiences and user involvement in care planning.

We ran a questionnaire helping us to develop a new tool to measure user and carer involvement in care planning and will be used in future research studies where it will be developed into an audit tool to help NHS Trusts to measure quality user/carer involvement in care planning.

My paper draws together the information gathered from service users in the interview study which have been summarised through a framework with 10 themes of user involved care planning.

It was encouraging to see lots of nods of approvals when meeting with the centres as I went through the findings but it was also disheartening to hear that many service users still feel side-lined in the care planning process. Some people don’t even have an up to date care plan. Many service users don’t know that they can be involved in care planning. This is why the research was being done in the first place.

On behalf of the EQUIP research team, I would like to thank everyone who completed a questionnaire, took part in an interview or promoted the studies. We really value everyone’s input and time and energy; we really couldn’t have done it without your partnership in this!

If you would like to take part in a new EQUIP survey about mental health care planning please visit: https://limesurvey.humanities.manchester.ac.uk/index.php/187196/lang-en

Andrew Grundy (Research Associate, School of Health Sciences, University of Nottingham)

[1] Grundy et al., ‘Bringing meaning to user involvement in mental health care planning: a qualitative exploration of service user perspectives’ Journal of Psychiatric & Mental Health Nursing (Dec 2015) http://onlinelibrary.wiley.com/doi/10.1111/jpm.12275/abstract

[2] The EQUIP project website can be found here: http://sites.nursing.manchester.ac.uk/equip/

This blog-post summarizes independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (grant reference number RP-PG-1210-12007). The views expressed are those of the author and not necessarily those of the NHS, the NIHR or the Department of Health.

Hello My Name is Jonathan

 

Jonathan Wright
Jonathan Wright

Hi my name is Jonathan and I am the Involvement Centre Manager in Nottingham.  What does it mean to manage an Involvement Centre?  Well the answer is varied and never the same!

My job is not boring, sometimes challenging and can be very rewarding.  I often think of myself as having three bosses, my line manager, the Trust and all the volunteers that I work with and have a duty to make sure they are heard.

The reason I come into work is to improve and change services for people that receive them.  Which I believe is the main reason everybody in the NHS comes into work.  We (staff) just sometimes get a little pressured to deliver on targets that don’t always work for the person that is in front of you that day.

I hope the work we do within Involvement means that we can deliver on those targets without forgetting what is most important to those that receive treatment and care.  The care part is really important; the NHS is a world leader at ‘treatment’ but sometimes we fall down on the ‘care’ part, and its’ then that people feel dehumanised and frustrated.

Let’s talk to each other, find out what we all would like.  Be honest about what we can do, and completely honest about what we can’t do.  Ask ourselves ‘would that feel ok if it was my Mum being cared for’?

Involvement gives us a chance to stand back and think about services in this way.  We should always listen, but more importantly we should all be part of the solutions that we find.

That’s why I come to work – and not everyday is like that, but enough are.

If you’re interested in being a volunteer email: involve@nottshc.nhs.uk or call

0800 052 1415

Rosewood Gets Busy!

 

 

ROSIE'S 2.7.15 action shot

by Carol & Eric – Rosewood Involvement Volunteers

Hello again, I’m Carol and I’m conscious that I haven’t done any blogging for ages due to being so busy! Here are some of the things I have been involved in as a volunteer in the last month:

Bassetlaw ‘Live!’ Events

Alzheimer’s Support Group

Recovery Conference at Rampton* (see below)

Interviewing at Wathwood for General Manager and Occupational Therapist

15 Step Challenge at Wathwood and Rampton * (see below)

County Carers Group

Directorate Recovery Involvement Group Meeting at the Ladies Unit at Rampton

Mental Health Awareness Event for Carers

Recovery Stories for Mental Health and Learning Disability at Rampton

Involvement and Experience Group

Meeting about Peer Support in Forensics

Although I have been so busy, the work I have been doing has been very rewarding for me. I hope that I have made a difference in some small way. My own recovery continues which means that I have progressed to supporting new people coming into Rosewood Centre on a Friday.

My Week in Involvement

Hello my name is Eric. I am a volunteer at the Rosewood Involvement Centre in Ollerton. Here is a brief account of my involvement activities over the last week.

I went to the Women’s unit and the Personality Disorder wards to do a ‘15 step challenge’ * this is a way of assessing the feel of a ward on first impression. The things we look out for are basic health and safety, friendliness, décor, patient activity etc.

During the week, I had the privilege of talking to fourth year medical students about my 30 years’ experience of mental instability and subsequent recovery. This session called “Story Shop” took place at Queen’s Medical Centre in Nottingham.

Later in the week, I attended a Recovery Event* at Rampton Hospital where volunteers told their personal stories of Recovery. This was followed by refreshments and then a sing-along performance from The Rosewood Rockers.

The week drew to a close with the usual Music Group in the morning which I lead. We are busily preparing for Christmas with rehearsal’s to be pitch perfect for the festivities!

The following week I had the opportunity to work with an ex-Rampton patient who was just about to move into his own house in the community.He will be telling his own Recovery Story at a conference in December.

Thanks to Carol & Eric for sharing their voluntary work experiences.

For more information about becoming a volunteer or to  Volunteer with us

Please contact  Jo Rapson: The Involvement Centre 0115 9934567

Joanna Rapson

Rosewood Centre Involvement Graphic
Our lovely Involvement Frieze by Emma Kitchen

 

 

Rosewood Involvement Centre Friday Meetings

by Sheila & Stephen – Involvement Volunteers (Aka Q)

The Rosewood Involvement Centre holds a centre meeting every Friday afternoon, in Ollerton in North Nottinghamshire. This meeting is for Involvement volunteers with guest speakers and staff sharing their experiences and information together. Sometime we receive training at the meeting to help us with our volunteering activities. The meeting usually kicks off with a sandwich lunch prepared by our volunteers which is a good way to get to know staff and new volunteers too.

Discussions are wide and varied such as the Executive Leadership Council (ELC).

The Executive Leadership Council (ELC) is made up of 150 senior members of the Trust. They meet on a monthly basis to share and discuss the leadership and direction of the organisation.

New volunteers joined the council in September 2015. Volunteers are expected to feedback to the Rosewood Friday meeting about ELC so that Involvement Volunteers have some awareness of what happens in our Trust at senior level. It helps us to understand how the Trust is thinking and moving forward.

We are encouraged to feedback about our involvement work in the meeting. Paul R, Involvement Volunteer, shared his experience at one meeting about The Kings Fund Conference in London. The subject was “Improving access to Mental Health” through digital means. Involvement is really varied and finding out what is going on in other parts of the country can be really useful to help us in Involvement.

Updates from other Involvement meetings are shared in the Friday meeting such as the ‘Routes to Employment’ meeting held at Duncan McMillian House Nottingham which is open to anyone with an interest in getting back to employment for people who have been experienced  mental ill health by raising awareness of the barriers in returning to work after being unwell.

Upcoming weekly events are shared such as ‘Bassetlaw Live’ Hospital Open Day, the Monday Communications Group, Carers Groups and Mental Health Awareness Weeks events.

Patient-led assessments of the care environment (PLACE) Audit Training is just one of the many opportunities held at Rosewood .The meeting encourages us to suggest things that may help in our roles as volunteers. E.g. A dance group was suggested to give volunteers some self-confidence, fun and help fitness.

New volunteers are welcome at Rosewood. Tel: 0115 993 4567 for more information

E-mail: involve@nottshc.nhs.uk Twitter: @InvolveT1

Hello , My name is Alan.

Rosewood Rockers
The Rosewood Rockers

Hello , My name is Alan.

I’m a volunteer and service user at Rosewood Involvement Centre in Ollerton.

I like to meet & greet new people into the centre, with tea in hand and a welcoming smile.

I joined Rosewood about a year ago and quickly settled into helping out in the centre.  I particularly like helping to set up the meeting room ready for visiting speakers, so if they need the projector I set this up for them.

I also like to help with the hospitality – helping with the buffet, getting drinks etc…

I like to keep things in order and this is the same in the Rosewood building.  So I ensure that the different rooms are clean & tidy and everything is put in its right place so the building and the use there of is safe.

Recently we have formed a new band from the regular music group here at Rosewood – our band is called ‘Rosewood Rockers’.

As a group we have “toured” both old peoples ward and mental health wards within the trust.

We were also privileged to be able to perform in Rampton.

And we regularly entertain visitors to Rosewood!

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.