Supporting Your Journey
Monday, 7 and 21 September 2015
Thank you to everyone who attended our second service user conference. Listening to feedback, we split this conference into two to allow more people to attend across the county. The first conference was held at St Martins Hospital in Canterbury, the second at Maidstone Football Ground in Maidstone. It was encouraging to see more of you attend both conferences so we will keep this format for the next conference. We will continually review however so do let us know if you feel this isn’t working.
Chief Executive Angela McNab welcomed delegates to the conference and gave an update on the results from the CQC inspection which were published in July of this year.
One important aspect that the report highlighted was the caring nature of our staff and it is encouraging that the CQC thought that our staff went beyond the call of duty. Our Forensic and Specialist Services were rated high and Learning Disabilities were rated as good.
The CQC has recognised that we have made a lot of progress however there are four areas which require improvement.
The first of these is that we are not consistent in processes in some parts of the Trust, for example care plans are not documented as well as they should be. The parts of the Trust that have been rated as excellent and good are sharing their expertise to help improve those services that were identified as requiring improvement.
The second of these was the quality of buildings. We only have a certain amount of capital that we can spend each year. We have made some improvements by building new wards and modernising areas. We have also re-prioritised our estates and we are continuing work on refurbishing the 136 suites.
Many of our services are over-demand with high occupancy in beds and high caseloads. We are working with commissioners to ensure appropriate admissions and alternative support is available, and will achieve this by working together.
The warning notices put on our older peoples unit has now been removed. We have a strong action plan to address issues with some of this work already underway.
Out of area beds
We were joined by Ivan McConnell in Canterbury and Malcolm McFrederick in Maidstone to talk about out of area beds. Both gave an overview of actions that have been taken to reduce demand on the acute service including care home support, liaison psychiatry, street triage and caseload management. However we still continue to experience pressures on our services and there is still work to be done. This includes:
- working with commissioners to identify what capacity is needed and determine what alternatives can be put in place to ensure appropriate admission and alternative support is available.
- daily monitoring with CCG/KCC weekly reviews and active management to ensure patient receives care in the most appropriate place.
- single point of access will help and go live in 2016 in addition to improved working with police and SECamb.
We welcomed two Open Dialogue experts at our conferences who gave an overview of the project and the Trusts involvement. One of only four Trusts in the UK to take forward Open Dialogue, the Trust has invested in training 17 people in this innovative project.
Open Dialogue is a model of care used since early 1980s in Finland. It is based on the needs of the individual, empowering social networks and friendships within the treatment process.
Single point of access
Members of the Single Point of Access project team joined the conference to update delegates in the introduction of a single phone number that will enable people to get a clinical response 24 hours a day.
The team have undertaken workshops with service users, carers and members of staff to ensure the service is designed by those who will use it. Once the project is complete, clinicians will be available to speak to service users with the potential to give a clinical judgement and mini assessment. This is not a tool to replace the crisis team, it is to help service users get the right treatment at the right time.
If anyone has any questions they can contact the project team on 0300 222 0123.
Peer Support Workers
We were then joined by Natalie Livesey and Louise Jessup, Peer Support Lead for the Trust.
Natalie explained that peer support is a therapeutic relationship that is an equal one with mutual respect and empowerment between people that have lived experience of mental health and not based upon the traditional model of ‘helper’ and ‘helpee’.
The Trust currently has 24 Peer Support Workers working with acute, community, early intervention and rehabilitation units.
Evidence has already been established that peer support makes a difference. It is a recovery focused way of working. Natalie and Louise would welcome enquiries from anyone who is interested in becoming a peer support worker.
This can be done by the Job Taster programme, joining the KMPT Bank and voluntary work.
This session ended with some fantastic comments from service users who had been helped by their peer support workers.
“I am on track, to the point I will be discharged soon. That’s due to my peer support worker."
“My worker helps me keep a balance.”
Nick Dent started the next session with an overview of the appreciative enquiry method. Nick was joined by service user David Hough who had taken part in the enquiry. David confessed he was sceptical at the beginning but now believes the method would be beneficial across the Trust. The Appreciative Enquiry model is based on two principles:
Those involved in operating and participating in a given system are best placed to determine how that system can be improved;
Whatever is the focus of an investigation tends to increase, both in terms of significance and commonality.
It uses the 4D cycle:
Discovery – the best of what is - appreciating
Dream – what might be – desired future – envisioning results
Design – what could change – co-constructing
Destiny – how to empower, learn and adjust/improvise – sustaining.
Guy Powell went on to discuss care planning and a review of how care planning is undertaken across the Trust. He focused on three areas of care planning that the national patient survey results indicate the Trust needs to improve.
- Ensuring people’s views are taken into account when planning their care.
- Including the goals that the service user would identify for themselves in care plans.
- Ensuring service users are ‘given enough time to consider their condition and treatment’.
Delegates were then given details about the work underway to ensure that training is embedded across the Trust with online and mandatory one day training for some people. This would then be embedded with care planning champions, peer audit and a CPA review checklist and leaflet.
Guy suggested all the elements to care planning was like a house structure, take any part of the build away and it fails. You can see his imagery in his presentation.
Primary Care and the Trust – working together
During our table discussion, we asked delegates to tell us what is working well and what are the challenges and of course what else we can do to make improvements. The feedback will be taken away and reviewed as we continue our work to improve working with primary care and the transition between services.
Facilitators fed back from the discussions:
“Area of good practice around primary care, health workers are supportive when someone comes back from secondary care. There are a few issues around Improving Access to Psychological Services (IAPS). It can take a while before secondary services see them. Concerns that under our services, patients may benefit from IAPS support. Useful to have issues around interface and secondary support.”
“There is a long waiting time for referrals from primary care to secondary care. It is like table tennis- patients are the ball that get batted around. GPs don’t always know appropriate service to refer patients and can sometimes get it wrong. Why can’t we as a Trust make the decision?”
“There is a lack of communication between service and GP. The service user is expected to go to the GP which can be difficult as patients cannot always articulate."
The power point presentation for the conference can be found here. If you would like a hard copy posted to you, please contact email@example.com.
We look forward to welcoming you to our next conference in 2016.