Implementing the Triangle of Care - a ground

Implementing the Triangle of Care - a ground

Implementing the Triangle of Care - a ground up approach! The Triangle of Care Good Practice Event Wednesday, 8th May 2013 Amanda Cummins, Senior Service Manager - Mental Health Carers Sutton Carers Centre. . Who we are 5 carer-focussed third sector organisations all with mental health carer specialist services All working within SWLStG NHS MH Trust a Trust covering 5 Boroughs, Wandsworth, Kingston, Richmond, Merton & Sutton All of us share the same core aim but have different resources, culture, funding streams, history, experience and focus But..

We all have shared values. The same drive to support carers, friends and families of people caring for someone with a mental health issue A commitment to working together to get the best result A belief in the Triangle of Care as a vehicle to achieve this Closing the Triangle of Care Carers Included: A Guide to Best Practice in Acute Mental Health Care A disconnected model of involvement Can lead to

carers being excluded at certain points of the care pathway failures to share information around risk assessment and care planning requests from carers for information, support and advice not heard carers unique and expert view of the person using services can be missed Closing the Triangle of Care Carers Included: A Guide to Best Practice in Acute Mental Health Care Its a simple solution The 6 standards of the Triangle of Care 1) Carers and the essential role they play are identified at first contact or as soon as possible thereafter 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 relevant range of information across the acute care pathway 6) A range of carer support services is available And regular assessing and auditing to ensure these six key elements of carer engagement exist and remain in place. The Triangle of Care Suttons' Story Our journey 2003 2006 Started supporting pre-existing

ward carers support group and promoting Carers Centre. Came across Closing the Triangle of Care that outlined the 12 strategies for improving carer engagement in in-patient settings.

20072008 Undertook research project on the Jasper Ward using appreciative inquiry to assess strengths and weaknesses. Nov 2009 Early 2010 Commissione

d by NHSSM to undertake Mental Health Carer consultation in Sutton and Merton. Developed project plan Closing the Triangle of Care from the ward into the community. Late 2010

Jan 2011 Jointly commissioned by LBS and NHSS&M to implement project. Carers Support & Developmen t Worker in post and Launch of the Triangle of Care on Jasper Ward

2003 to 2012 the progress of Closing the Triangle of Care project The Triangle of Care Suttons Story Our journey Jan - July 11 Aug - Dec 11 Jan - July 12 - S&D worker presence on ward. - Attendance at ward rounds - Carer drop-in during evening. - Carer info pack developed

- Carer lead identified - Audit carried out and action plan developed - S&D worker attending ward rounds - Review of Carer drop-in - Carer Info survey carried out - Review of action plan following further audit - SE regional Launch - Negotiations with CMHT - Exploration in

regional specialist deaf unit - Ward transferred location to new premises - CMHT launch put on hold due to reconfiguration - Carer Lead and Consultant psychiatrist joined regional subgroup for CTC - Yammer group established for Carer Leads - Young Carers post recruited through BLF - Social Work Carer

lead identified and Carer Awareness training package facilitated Nov - Now Aug - Nov 12 - CMHTs reconfigured - Further ward audit and adapted carer audit developed - Support to neighbouring Carers Centre around implementation - Handover from one S&D worker to another - ToC membership scheme launched and

SWLStG sign up -Developing training package for staff - Working closely with carer organisations locally -Developing partnerships within CMHT - Coproducing training package -Skilling up carer lead -Embedding whilst withdrawing from ward -Carer survey repeated for carers of people who use

community services 2011 to 2013 the progress of Closing the Triangle of Care project The questions for us..... How have we got where we are today? What were the challenges to date? What were the successes to date? How we got there...the differences We all shared tools, knowledge and experience We all had different methods of implementation and time-scales = How we got there...the similarities We identified that what was needed was: organisational cultural change was the most effective way to sustain long term developments

need for some consistency across the Boroughs in information (provision and sharing) and protocols and procedures buy-in at all levels was achieved through using Forum and groups as a platform for embedding ToC into policy and practice allies! Challenges Capacity Consistency Momentum All helped by the strength of Peer Support! Successes' to date (1) Each Borough reports individual specific successes Carers involved directly with promoting ToC Increased identification of carers & referrals to CC Trust-wide protocol for every carer to be invited within 2 weeks of patient admission

Carer surveys introduced via Real Time Feedback Carers accessing Recovery College courses Successes' to date (2) Reduction in complaints and increase in compliments Positive outcomes for carers wellbeing and involvement Good practice examples included in the original and current ToC Guide from SWLStG Sign up to the membership scheme The Trust-wide audits Trust-wide ward Audits Noted some issues of process around audit Report completed on emerging themes as well as many good practice examples Action plans to be developed Findings presented at internal and external meetings

Joint initiative meeting brought together Carers Lead, Borough leads and CC staff Trust-wide approach to Carer Awareness training agreed What we have learned... ToC is a framework that people understand The audits themselves start the change process Capitalise on every opportunity to promote the framework Whole family & system approaches are the most efficient, effective & safe way to support families There is also an increasing evidence base to show that not only do carers and families benefit from work such as CTC it also makes financial sense What we have learned... Cultural changes take time but are the most effective and sustainable longer term. Finding allies internal to your organisation and

within external organisations is essential in order; to offer holistic support to families build capacity within organisations Demonstrating a united voice around carers issues and mutual respect for each others work was essential to maintain the strength and validity of the messages From the ground up... Involve Plan evaluate Develop Partnerships Initiate

monitor Collaborate The future... Sustain cultural transformation during organisational and individual changes Build links and support/mentor each other and areas within the MH Trust who are developing their own action plans Work to maintain internal organisational capacity especially whole family work and young carers To continue to promote the approach with service users, other third sector and public organisations e.g. Local Authorities Sell the product to GP and LA commissioners Related website addresses

http://static.carers.org/files/caretriangle-web-5250.pdf http://www.carers.org/press-release/investment-%C2%A35million-yields-more-%C2%A373-million-year-carers? dm_i=AYZ,GOK0,1V1G28,1CZ1Q,1 http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/ PublicationsPolicyAndGuidance/DH_122077 http://static.carers.org/files/supporting-carers-the-case-forchange-5728.pdf http://www.idea.gov.uk/idk/aio/13295835 Implementing the Triangle of Care - a ground up approach! Questions? Amanda Cummins, Carers Service Manager Mental Health Kelly Newman, Senior Support & Development Worker- Mental Health Carers Sutton Carers Centre. Margaret Whittle, Support & Development Worker Mental Health Carers Support Merton Veronica Attah, Carers, F & F Support Service Co-ordinator- MH & Substance Misuse Kingston Carers Network [email protected] [email protected]

[email protected] [email protected]

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