Newsletter

Welcome to the January 2022 edition of the Forensic Inpatient services Family, Friends and Carers Newsletter.

What’s new?

It’s been a busy time since our last newsletter with some changes to senior roles within the Trust and the Forensic and Specialist care group, a CQC inspection, local and Trustwide changes to guidance around COVID-19 and its impact on visiting and leave as well as the festive season itself.

Changes to roles:

We have seen the appointment of a new Chief Operating Officer and a new Interim Head of Service for the Forensic and Specialist care group (following the departure of Emma Willing who we introduced in our last edition).

Our new Chief Operating Officer

We are pleased to announce that Donna Hayward-Sussex has been appointed to the role of Chief Operating Officer at KMPT.

Donna will join the Trust in March from her current role as Service Director at South London and Maudsley Foundation Trust.

Donna combines a strong management background with extensive experience in operationally leading and developing mental health services in the NHS and voluntary sector.

Donna is a psychotherapist by background and is delighted to be joining the organisation and said: “I have really enjoyed my contact with KMPT so far and have already met many committed and talented colleagues. I look forward to joining the organisation in the Spring and getting to grips with what I know will be some important opportunities to build on the substantial successes KMPT has delivered to date.”

Our new Interim Head of Service for the Forensic and Specialist care group will be announced soon.

CQC inspection

As you may be aware, towards the end of 2021 the Care Quality Commission (CQC) carried out an inspection of our services. They inspected two locations over two days – the Trevor Gibbens Unit in Maidstone and The Allington Centre at Dartford.

During the inspection, the CQC team spoke with staff and patients and we know that they were planning to speak with families, friends and carers too. We are awaiting this feedback and their final report and will share more details when available.

In the meantime, we are pleased to be able to share some of their initial feedback with you:

• At all sites we were well-received and staff were very helpful and flexible and really willing to show us their service and talk about patient care
• Overall at both locations there were stable staff teams with staff that knew the patients well. Although some staff commented that at times they had some fatigue from working with bank staff, however recruitment had been successful for most vacancies
• There was evidence of solid risk assessments which were reviewed regularly and also good quality care plans which also included recording of physical health and co-morbidities
• At both sites the MDT had the skills necessary to work with the patients and we saw that they were comfortable working effectively with each other
• However, we did see concerns with the environment and maintenance of it
• At Allington Centre patient access to the inner courtyard space appeared to us to be excessively limited and in need of review
• Staff and patients raised concerns about how the food is organised, the choice of food and the portion size. We saw staff at both locations doing everything they could to improve patients experience of food
• We saw good standards of medicines management---prescribing and administering
• The patients we spoke with were universally positive about the staff and the impact of the service and also the FOLS (Forensic Outreach and Liaison Service) team
• We saw good evidence of rapport between patients and staff
• And finally, a key observation was that that the wards were relaxed and the patients seemed confident and alert, and comfortable in the environment.

We wanted to say a big thank you to everyone who was willing and/ or able to share their views and experience with the inspecting team. Thank you!​

COVID-19: The KMPT journey continues

As you know, we have faced further challenges with COVID-19 and in particular the Omicron variant which has impacted on some of our ways of working recently.

We had to lock down some of our wards over the Christmas period and we know that this may have been particularly difficult for you and your loved ones. We’ve also recently faced some temporary Trustwide restrictions to leave and visits and we thank you for playing your part in keeping our patients, staff and community safe during this time.

Whilst the situation with COVID-19 is ever evolving, the current guidance for leave and visits is as follows:

To minimise the spread of COVID-19 and to continue to protect the safety of our patients, their loved ones and our staff, we will be following a controlled approach as follows:

If you would like to visit a patient on our wards
Visits should be made by appointment only, unless there are extenuating circumstances.

All visits will take place in a dedicated, ventilated room with enough space for safe social distancing. The maximum visiting time is one hour.

We would kindly ask that visitors:

• Take a lateral flow test before arriving and do not visit if you or any member of your house have a positive diagnosis of COVID-19
• Wear a face covering at all times, unless medically exempt
• Wash and sanitise your hands before and after your visit
• Bring as few personal belongings with you as possible, including gifts and food for the person you are visiting

If an inpatient tests positive with COVID-19
For inpatients with COVID-19, isolation has been reduced to 10 days after the onset of symptoms or their first positive COVID-19 test if they do not have any symptoms, provided the individual no longer has a fever and has no underlying severe immunosuppression.

If the patient continues to present with a fever, isolation must continue until they are fever free for 48 hours. A cough or a loss of, or change in, normal sense of smell or taste (anosmia), may persist in some individuals for several weeks, and are not considered an indication of ongoing infection when other symptoms have resolved.

If an inpatient comes into contact with someone who tests positive with COVID-19
Inpatients who come into contact with a positive COVID-19 individual will need to isolate and have regular testing. This time has been reduced to 10 days.

We will do all that we can to keep you advised of any further changes that might impact on you and your loved one and the Trust will also keep our website updated too. You can find out more here on our news and events section

Forums and Feedback

We will be offering both online and in person Family, friends and carers forums throughout the year. Please see below details:

• Thursday 17 February, 5-6pm In person at Dartford
• Thursday 17 March, 2-3pm, Online
• Monday 25 April, 3-4pm, In person at Maidstone
• Tuesday 17 May, 2-3pm, Online
• Friday 17 June, 6-7pm, In person at Dartford
• Sunday 17 July, 2-3pm, Online
• Wednesday 17 August, 5-6pm, In person at Maidstone
• Saturday 17 September, 2-3pm, Online
• Monday 17 October, 6-7pm, In person at Dartford
• Thursday 17 November, 2-3pm, Online
• Saturday 17 December, 3-4pm, In person at Maidstone

The dial-in or specific location details will be shared ahead of the forum each month and our hope is that these sessions will provide a space to share ideas and queries as well as to meet up with other families, friends and carers too.

Feedback from the Forums…

We know that not everyone is able to join the forums so we thought we would share some of the topics that have come up so far, along with some updates from our teams:

At Trevor Gibbens Unit (TGU) we had some queries around the sinkholes on site and the potential impact of these on activities that are available to patients. 

Ongoing: The teams are working hard to ensure that patients are still able to access activities and fresh air in alternative locations. The matter remains with the Trust Estates Department. The works are still out to tender at present.

At Dartford it was raised that e-cigarettes are costly and it was asked whether any alternatives are available

Ongoing: This matter has been raised at the KMPT Trustwide Smoke Free meeting and a trial is currently taking place with an alternative (cheaper) brand at The Allington Centre. Generally feedback has been positive so far however the trial is ongoing and further information on the outcome will be shared when available.

It was raised that sometimes low secure wards can seem more restrictive than medium secure wards and that this can be a challenge for those transferring between the services

Ongoing: We continue to look at ways of working and creating systems which allow for more individualised patient pathways. There is a Care Group Restrictive Practices Group and quarterly meetings are being relaunched to look at reducing restrictive practice. Each service either has or is in the process of setting up local subgroups that will link in with the Care Group forum. These meetings will review matters such as reducing blanket restrictions (i.e. rules or policies that restrict a patient’s liberty and other rights, which are routinely applied to all patients, or to classes of patients, or within a service, without individual risk assessments to justify their application.)

Staffing and recruitment query, in particular in relation to OT (Occupational Therapy) cover at the TGU

It is acknowledged that there have been challenges with recruiting Allied Health Professionals (AHPs) such as Occupational Therapists (OTs) and that this has been a theme across the country and not just at the TGU. The TGU have been able to recently make offers for all bar one vacant post and efforts are ongoing to ensure that we recruit the right people for the service. It is also. acknowledged that Trust recruitment processes have impacted on the speed at which the service has been able to respond to this matter.

Visiting facilities (indoors and out) 

Work is planned to improve the visiting facilities at both the TGU and the Dartford site during 2022. This will begin with a focus on the main family visiting rooms at each site (behind Reception at the TGU and in Archery House at Dartford). We are keen to hear any thoughts that families, friends and carers may have in terms of how you would like the rooms to look and feel and what resources might need to be made available.

We are aware that the outside spaces also need some work. We have ordered additional benches for the grounds at the Dartford site and are waiting on funds to come through from The Friends of Mental Health (West Kent) charity as they have kindly agreed to purchase these for the benefit for patients and their visitors. A wildflower garden is also being developed at the Dartford site by our patients and given it’s location this will be accessible for visitors to also enjoy.

Travel and transport – costs and accessibility

Both patients and families have raised the matter of travelling for leave and visits and the associated costs. Please see the ‘Any questions?’ section for some further details around how we and other organisations may be able to help with this.

We have been asked why we are not offering lateral flow tests to patients, at least ahead of leave or visits?

There has been a national shortage of lateral flow tests at times and we have not had access to a supply of tests. In line with Trust guidance, we have instead been continuing to offer our patients a weekly PCR test. It is also of note that often the guidance for hospitals in terms of managing Covid-19 varies slightly from that for the general public.

We will work to keep you updated on any developments via the forums and newsletters and if you have any ideas regarding the format or timing of the forums moving forwards, please let the Family engagement and liaison lead know.

What's coming up?

Time to Talk Day is the nation’s biggest mental health conversation and it’s nearly here! Taking place on Thursday 3 February 2022, it’s the day that friends, families, communities, and workplaces come together to talk, listen and change lives. The day is run by Mind and Rethink Mental Illness in England, in partnership with Co-op. You can find out more about Time to Talk Day here

Young Carers Action Day is an annual event led by Carers Trust. It raises awareness and calls for action to increase support for young people with caring responsibilities. Young Carers Action Day 2022 is about Taking Action on Isolation and it takes place on Wednesday 16 March 2022. You can find out more about Young Carers Action Day here

We are excited to announce that on Monday 14 February, the Trust will be launching a new Family, friends and carer survey. The survey has been developed with the support of families and carers just like you who have experienced our services. We would really appreciate you taking the time to tell us about your own experiences of KMPT and we will be sharing posters and copies of the survey in line with the launch. If you have any questions about the survey, please speak to the Family engagement  and liaison lead or the carers champion for your loved one’s ward.

Kent and Medway Recovery & Wellbeing College

The Kent and Medway Recovery & Wellbeing College are pleased to be able to continue providing shared learning spaces in the current circumstances. It is so helpful to stay connected in positive ways, add structure to our days and take part in things that feel productive. These three things make such a difference to how we feel and help us maintain resilience.

You can find out more about the virtual and in person courses that are available this term here and you can also find a link to an online enrolment system – it’s quick (it takes approx.10 minutes), easy and secure. Once you have submitted the form, someone from the Recovery College team will call you back to sign you up to your chosen courses! Alternatively, you can call the relevant location to discuss further:

Canterbury: 07833 442136

Ashford: 07825 859412

Virtual: 07787 266421

Want to get more involved at Recovery College?

If you are interested in volunteering or becoming a facilitator, please attend the monthly Student Room to find out more information from the team. You can also complete a survey here or text or call: 07787 266 421

To discuss Recovery Colleges outside of Kent and Medway, please speak to your Family engagement and liaison lead.

Caring is sharing

Do you have any tips, ideas, suggestions or information that you would like to share with other families, friends and carers?

Perhaps you have come across some information about carers rights, or a local support group or organisation who you have found really helpful and you would like to let other people know? If so, we would like to give you the opportunity to share these via our newsletter…just let your Family engagement and liaison lead know and we can add to our next edition.

A Caring Mind is a blog by Matthew McKenzie about caring and mental health. Matthew is a former mental health carer who runs many carer forums and support groups in South London including the Bromley, Lewisham, Greenwich & Bexley BAME Mental Health Carers Forum which was recently promoted via the KMPT Engagement Pool.

Matthew shares interesting and useful links for carers or those with lived experiences. He is heavily involved in mental health services and often promotes service user or carer involvement in health and social care. You can find out more about Matthew’s work and forums

Matthew has recently published a new book aimed at capturing the challenges faced by carers with insight from unpaid carers, NHS staff, lived experienced survivors and researchers on what mental health care looks like. This can be purchased from Amazon and he is currently working on carer awareness poetry too.

If you’d like to find out more about different mental health diagnoses or treatments, the Royal College of Psychiatry produce readable, user-friendly and evidence-based information on mental health problems, treatments and other topics, written by psychiatrists with help from patients and carers.

You can search online here: www.rcpsych.ac.uk/mental-health

Carers Trust provide information about online courses, some of which are just for carers and many of which are free to access. The types of courses referenced include: physical activity for health and wellbeing in the caring role, caring for adults, digital courses - using computers, tablets, the internet, social media and mobile phones. You can find out more about the courses here

There are many more sources of information online too but if you are not able to or would simply prefer not to access information online, please just let us know and we will see what we can find to send to you as a paper copy. This applies to any of the topics covered in this newsletter too.

Carers rights

We know that not everyone identifies as a carer but as someone supporting a loved one, it is important that you are aware of some of the rights you may have. As highlighted by Carers UK during Carers Rights Day on Thursday 25 November 2021, these include, the right to:

• discuss flexible working options
• protection from discrimination
• request a free flu jab
• receive a Carer's Assessment*
• be identified as a carer
• be consulted on hospital discharge

Each edition we will focus on one of the rights in more detail – today, we will share information from Carers UK regarding flexible working options…

Juggling work and care can be very challenging, so it’s important to understand the rights you have both in law and with your employer.

Your rights in work come from two sources:

• the law gives you ‘statutory rights’ which everyone has
• your contract of employment gives you ‘contractual rights’ which can be more generous than statutory rights.

If you're looking for information on your rights or how to prepare yourself to discuss flexible working with your employer, Carers UK have lots of information available here

Don’t forget, you may be entitled to a Carer’s Assessment

Many carers find it easier to continue in their caring role if they can get some assistance. If it appears that they have needs for support, they can have a Carer’s Assessment.

Local councils can provide care and support for people who require care, and their carers. The way they make a decision about the support that they can provide is by carrying out assessments.

You can find out more about eligibility, the process for applying for an assessment and the sorts of support that might be available to you here

Any questions?

Is there something you’ve been meaning to ask but weren’t sure who to go to or you think other family, friends or carers might also be interested in the answer?

If so, just let us know – any questions can be submitted to your Family engagement and liaison lead and we will do our best to include the answers in the next edition.

Question

I’d like to come along to my son’s CPA but I don’t drive and it’s not always possible to get a lift, plus public transport can be a struggle too. Is there anything you can suggest as I’d really like to be involved and I don’t get on well with computers?

Answer

We know that travel can be a real challenge for a number of reasons and if you are looking to arrange a visit or to attend a meeting at one of our services then please get in touch with your Family engagement and liaison lead or your loved one’s social worker and we can ask our Voluntary service team whether they may be able to help.

Our Voluntary services team cover a wide range of services including arranging transport. We would need to know the date, time, duration and location of a trip and the team will share with their drivers to see whether anyone is able to support.

The team can’t always find someone but with a bit of notice they will do their best. If a driver is not able to do a complete journey (for example from a very long way away) then they may be able to support with a pick up from a nearby train or bus station for example.

We can also look into transport if you’d like to come along to any of our in-person Family, friends and carers forums. If you’d like to discuss accessing voluntary transport services further, please just let us know.

Local Carer support organisations can advise on Carers Assessments and benefits which might be helpful if you are concerned about the financial impact of travelling to meetings and visits.

Some of these organisations are also able to provide transport too. Other organisations might also be able to offer grants. The Friends of Mental Health West Kent for example can look at supporting patients with one-off journeys and organisations such as

Turn2us can provide information on grants

Question

I’ve always been involved in my son’s care and come along to meetings etc. What meetings do you have here that I might be able to attend?

Answer

We value the important role that you play in your loved one’s care and with their agreement, you may attend and/ or provide your views in meetings including the following:

• Ward rounds
• Care Programme Approach meetings (CPA)
• Care and Treatment Reviews (CTR)
• Mental Health Review Tribunals (MHRT)
• Manager’s Hearings

In most cases your loved one will be asked who they would like to attend their meetings and invitations are sent accordingly.

If you would like to find out more about any of these meetings and how to get involved, please speak to our teams.

The Triangle of Care

The Triangle of Care is a therapeutic alliance between patients, their ‘carers’ and professionals.

There are 6 standards to the Triangle of Care:

• Carers and the essential role they play are identified at first contact or as soon as possible thereafter
• Staff are ’carer aware’ and trained in carer engagement strategies
• Policy and practice protocols re: confidentiality and sharing information are in place
• Defined post(s) responsible for carers are in place
• A carer introduction to the service and staff is available, with a relevant range of information across the acute care pathway
• A range of carer support services is available.

Each edition we will focus on one of the standards and share some of the work we are doing to support the standard.

Today’s focus is standard 1
Carers and the essential role they play are identified at first contact or as soon as possible thereafter.

• We aim to meet this by speaking with your loved one on admission about the people in their life who are important to them. We will discuss who they would like to stay in contact with and who they would be agreeable to our teams reaching out to
• We recognise that often people will not see themselves or their loved ones as ‘carers’ however we will aim to reach out to any family members and / or friends who are identified as providing a supporting role
• We will reach out to discuss your own experience, the ways in which you might like to be involved in your loved one’s care and any support needs that you may have
• We will share information about our services and introduce you to our Family Engagement and Liaison Lead and the support available from them and the ward Carer Champions
• We will invite you to a Meet & Greet with your loved one’s team early on in their admission
• We will listen and hear what you have to say.

Our services complete self-assessment reviews in relation to the 6 standards of the Triangle of Care on a regular basis. If you would like to be involved in the next review for your loved one’s ward, please let the Family engagement and liaison lead know.

Get involved (opportunities)

Including the views and experience of our patients and their families, friends and carers in improving and developing our services helps us to get it right.

Please see below some of the latest opportunities:

• Refresh of the KMPT family, friends and carers charter
• 8x8 telephony project workshop for service users and carers
• Facilitating improved collaboration with families in older adults inpatient services
• Autism and psychosis carers research with Kings College London Institute of Psychiatry, Psychology and Neuroscience
• NCEPOD transition study collecting the views of young people and parent carers on the transition process from child to adult healthcare services
• Consultation on the KCC draft Adult carers strategy
• Joint Carers Conference

We will keep sharing updates on opportunities to get involved in local, Trust-wide and external projects and meetings when available.

If you are passionate about service improvement, please get in touch with: Kamila Lobuzinska, Patient engagement coordinator, on 07917 513426 or email kmpt.engagement@nhs.net

Future editions

We hope you enjoy this latest newsletter and would love to hear your feedback and/or ideas for future content.

The next edition will be coming out in April 2022 so please get in touch between now and then if you’d like to get involved…

Contact us if you have any questions

Your Family engagement and liaison lead is Hayley Mason.

You can contact her by calling 07880 473366 or

emailing kmpt.forensiccarersupport@nhs.net