Scottish Recovery Network

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Simon Bradstreet SRN Allison Alexander NHS
Education for Scotland/SRN Scottish Recovery
Indicator

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SRI workshop

• Introduce SRN and NES work around Mental Health
  Nursing Review
• Introduce the Scottish Recovery Indicator tool
• Consider how to use SRI to help achieve improved
  outcomes

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The National Programme

• Improving the mental health and well-being for
  everyone living in Scotland and improving the
  quality of life and social inclusion of people
  experiencing mental health problems.

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What we aim to do

• SRN aims to
• Raise awareness of recovery
• Develop our understanding of recovery
• Build capacity by sharing information and by
  supporting efforts to promote recovery

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Why develop a practice tool

• To assess the extent to which practice is
  focussed around recovery
• To help people realise principles of recovery in
  practice
• To make recovery more tangible
• Are we really doing this already?

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Values base for mental health nursing Relationshi
ps Rights Respect Recovery Reaching
out Responsibility
A The recovery approach should be adopted as
the model for mental health nursing care and
intervention, particularly in supporting people
with long-standing mental health problems.
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• Some relevant actions
• All mental health nurse will undertake values
  based training
• National framework for training in recovery-based
  practice to support the dissemination of
  recovery-focussed frameworks into practice
• Mental health nurses will use recovery
  environment audit tools to gauge their current
  practice and to inform the development of
  recovery based approaches

The recovery approach should be adopted as the
model for mental health nursing care and
intervention, particularly in supporting people
with long-standing mental health problems.
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NHS Education for Scotland / SRN Joint project

• To produce a framework for mental health nurses
  outlining the knowledge, skills and values needed
  to work in a recovery focussed way
• Underpinned by the lived experience of service
  users, SRN Narrative Research and training
  currently available
• Literature review

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Delivering for mental health
Improve the patient and carer experience of
mental health services
Commitment 1 We will develop a tool to assess
the degree to which organisations and programmes
meet our expectations in respect of equality,
social inclusion, recovery and rights. The tool
will be piloted in 2007 and be in general use by
2010.
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Development of SRI

• Assessed existing tools and approaches
• Identified Recovery Oriented Practices Index as
  viable option
• How ROPI was developed
• Adaptation process
• From stick to carrot
• Piloting SRI and evaluating impact

Mancini, A.D., and Finnerty, M.T. (2005).
Recovery-Oriented Practices Index, unpublished
manuscript, New York State Office of Mental Health
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SRI headings

• Meeting basic needs
• Personalisation and choice
• Strengths-based approach
• Comprehensive services
• Service user involvement/participation
• Involving support networks and promoting social
  inclusion and community integration
• Service user in control and active participant
  even when subject to compulsion
• Recovery focus

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Using SRI

• Preparing to use SRI
• Training
• Gathering information and people
• Answering the questions
• Sampled service user records (Assessment forms
  and Care Plans)
• Project information/documentation
• Practitioner and service user interviews
• Acting on the findings

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Example 1 Assessment information
3. Strengths-based approach 3. Strengths-based approach 3. Strengths-based approach 3. Strengths-based approach 3. Strengths-based approach 3. Strengths-based approach
Indicating that service delivery and planning should be focussed on service users strengths. Indicating that service delivery and planning should be focussed on service users strengths. Indicating that service delivery and planning should be focussed on service users strengths. Indicating that service delivery and planning should be focussed on service users strengths. Indicating that service delivery and planning should be focussed on service users strengths. Indicating that service delivery and planning should be focussed on service users strengths.
1 2 3 4 5
3a. Assessment addresses service user strengths in multiple areas. Assessment does not address service user strengths Assessment Includes one aspect relating to strengths Assessment addresses strengths in multiple areas of functioning
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Example 2 Care plan information
2. Personalisation and choice 2. Personalisation and choice 2. Personalisation and choice 2. Personalisation and choice 2. Personalisation and choice 2. Personalisation and choice
Indicating that the planning and delivery of all services be designed to address the unique circumstances, history, expressed preferences and capabilities of each service user. Indicating that the planning and delivery of all services be designed to address the unique circumstances, history, expressed preferences and capabilities of each service user. Indicating that the planning and delivery of all services be designed to address the unique circumstances, history, expressed preferences and capabilities of each service user. Indicating that the planning and delivery of all services be designed to address the unique circumstances, history, expressed preferences and capabilities of each service user. Indicating that the planning and delivery of all services be designed to address the unique circumstances, history, expressed preferences and capabilities of each service user. Indicating that the planning and delivery of all services be designed to address the unique circumstances, history, expressed preferences and capabilities of each service user.
1 2 3 4 5
2b. Care planning should reflect personalised self-set service user goals, with substantial variation across care plans. Care plans are standardised, with minimal to no variation Care plans show minimal variation in goals, with 90 of plans having at least 1 similar or identical goal (e.g. psychiatric stabilisation, medication compliance) Care plans show moderate degree of variation in goals, with 50-89 of plans having at least 1 similar or identical goal Care plans show high degree of variation in goals, with 20-49 of plans having at least 1 similar or identical goal Care plans show substantial variation in treatment goals, with lt 20 of plans having at least 1 similar or identical goal in most recent care plan
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Example 3 Project information
5. Service user involvement/participation 5. Service user involvement/participation 5. Service user involvement/participation 5. Service user involvement/participation 5. Service user involvement/participation 5. Service user involvement/participation
Indicating service user involvement as integral to the planning and delivery of all services and to the determination of policies and procedures for service operations. Service should also actively recruit service users who are hired with equality in pay, benefits, and responsibilities to other employees. Indicating service user involvement as integral to the planning and delivery of all services and to the determination of policies and procedures for service operations. Service should also actively recruit service users who are hired with equality in pay, benefits, and responsibilities to other employees. Indicating service user involvement as integral to the planning and delivery of all services and to the determination of policies and procedures for service operations. Service should also actively recruit service users who are hired with equality in pay, benefits, and responsibilities to other employees. Indicating service user involvement as integral to the planning and delivery of all services and to the determination of policies and procedures for service operations. Service should also actively recruit service users who are hired with equality in pay, benefits, and responsibilities to other employees. Indicating service user involvement as integral to the planning and delivery of all services and to the determination of policies and procedures for service operations. Service should also actively recruit service users who are hired with equality in pay, benefits, and responsibilities to other employees. Indicating service user involvement as integral to the planning and delivery of all services and to the determination of policies and procedures for service operations. Service should also actively recruit service users who are hired with equality in pay, benefits, and responsibilities to other employees.
1 2 3 4 5
5a. Service has policy and formal mechanism for involving a diversity of service user input that has resulted in demonstrable changes in policies, procedures, or provision. Policies do not specifically address diverse service user involvement in activities or operations and there is no formal mechanism for promoting involvement Policies exist regarding diverse service user involvement but no formal mechanism for promoting involvement Policy and formal mechanism for promoting diverse service user involvement exist but mechanism is cursory (e.g. yearly satisfaction survey) and has not significantly informed development Policy and formal mechanism exist for promoting diverse service user involvement that has resulted in at least one significant change (must identify this change) (In addition to 4) There is service user advisory board and/ or service user(s) on governing body. Service users also contribute to staff appointment process and training
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Example questions

1. Do these criteria make sense to you?
2. What evidence or examples could your service
   produce to meet the criteria?

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Key issues

• Who to involve in gathering and assessing
  information?
• Who to involve in answering questions?
• Maintaining morale
• Confidentiality and ethics
• Defining parameters of questions
• How best to involve service users
• How to act on findings

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Contacting us

• info_at_scottishrecovery.net
• Join SRN mailing list and access SRI draft
  www.scottishrecovery.net
• 0141 240 7790