Partnership Accelerating Change PAC 20067 Final Project Report

1
Partnership Accelerating Change (PAC) 2006/7
Final Project Report

• Rotherham Doncaster and South Humber Mental
  Health NHS Foundation Trust

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CPA Improvement Group

• Area of Improvement
• Experience of CPA for people who are on enhanced
  CPA register

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Project Team members

• Nick Arkle (Patient Experience/PSI Lead)
• Tom Wyman/Helen Oldknow(CPA Lead)
• Diane Swanson (Carers 4 carers, Rotherham)
• Anita Wilson (Phoenix Carers Group, Rotherham)
• Terry Boyle (Rotherham MIND)
• Suzzi Holden (Doncaster INVOLVE Group)

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What evidence led you to choose this particular
area for improvement?

• 2006 Community Mental Health Survey From the
  survey there was evidence that many people who
  are on CPA did not understand what was in the
  their care plan were not involved in deciding
  what was in the care plan and there was a lack
  of information regarding the care planning/CPA
  process.
• The PPI Forum for the Trust had also undertaken a
  review of the experience of CPA for service users
  and carers, which also indicated that there is a
  lack of information to support the process.

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What did you do?

• We undertook a literature search to explore what
  other Trusts had done in response to the
  problems, which are reported as common across
  many mental health trusts.
• From this we decided to develop a Care Plan
  Folder, based upon the work that had been
  undertaken in Essex, and published within the
  CPAA Journal.

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What did you do?

• Agreed an Action Plan, to include how managers,
  staff, service users and carers would be involved
  in the process.
• Developed a pilot folder, and sought feedback
  from service user groups, carer groups, staff and
  service managers.
• Have had folders printed.
• Met with Community Service Managers to agree
  process of distributing the Care Plan Folder,
  with staff to use as an aid to giving information
  regarding the CPA and Care Planning process.
• Planning to evaluate the impact of the Care Plan
  Folders for service users in early 2008, at which
  time most of those on enhanced CPA should have
  received their Care Plan Folder

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Action Plan
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How did you involve service users in this work?

• Service users and carers have been central to the
  work. Following the first training offered by the
  Picker Institute the PE/PSI Lead invited members
  of the Trust User Carer Partnership Council to
  become members of the CPA Improvement Group. The
  core members of the group are service users or
  carers. Through contacts with service user and
  carer groups the carer and service user members
  of he group have involved other service users and
  cares throughout the process. This has included
  meeting with people in day centres, MIND groups
  and carer groups across Rotherham and Doncaster.

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What changes have been implemented?

• The Care Plan Folder is being distributed to the
  1500 (approx) people who are on enhanced CPA.
• The development of the folder has raised the
  awareness of staff and managers to the need to
  ensure that good information regarding the CPA
  process is delivered.
• The folder serves two purposes
• 1.      Written information regarding CPA for
  service users
• 2.      Reinforcing staff to give information-
  they have specific instructions not to simply
  give the folder to service users, but to ensure
  that it is given as part of an information-giving
  process.
•  

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What changes have been implemented?

• Agreement from the Medical Director that photo
  boards will be used in out patient areas,
  highlighting the medical teams
• Service users and cares have had more direct
  contact with service managers as part of the
  process, a change that they say has empowered
  them.

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How have things improved for service users and
what evidence is there to support this?

• This is yet to be evaluated- we are currently
  planning to meet with individuals and groups of
  service users to gain feedback regarding the Care
  Plan Folder. Planning a questionnaire that can be
  sent to a sample of service users.

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How have things improved for service users and
what evidence is there to support this?

• The immediate improvement has been for the
  service users directly involved in the group, who
  report that they feel that the process and
  training given has empowered them to ask for
  changes to own care plan, or to demand from
  service provider that they have a written care
  plan.

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What lessons have you learnt?

• Working together works.
• Service users and cares can represent the trust
  in the absence of staff at training events.
• To make small incremental changes- there will be
  obstacles, but they can be overcome stick with
  it.
• It is hard but pleasurable work.

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 What plans are there to develop/roll out this
project more widely?

• Considering next steps
• Await the national consultation on CPA outcomes,
  due January 2008 this may offer some guidance.
• To develop a brief service user/carer
  presentation regarding the benefits of CPA and
  good Care Planning that can be delivered within
  team meetings to reinforce the need for the
  process to start with the individual.
• Supporting the development of CPA in Older
  Peoples and Learning Disability Services within
  the Trust.
• Paper written with Picker Institute submitted for
  publication.