Monthly Archives: July 2021

Research Study: Improving safety in community-based mental healthcare.

Hello fellow carers. I have exciting research news for you.

Phoebe Averill who is a PhD Student of the Health Service and Population Research Department from Institute of Psychiatry, Psychology and Neuroscience. Is working on a research study about the safety of community-based mental health services. This is a nationwide research aimed at unpaid carers.

Please see below for details.

What is this study?

We are carrying out a study to find out about safety problems in community-based mental health services for adults. This research will help to increase awareness of the types of safety problems service users and carers experience in these services, as well as gathering ideas about how community mental healthcare could be made safer.

Taking part would involve participating in your choice of either a one-to-one interview, or a group discussion. Interviews or group discussions will be conducted remotely via a secure online platform (e.g. Zoom), and will last for up to one hour.

Who can take part?

We would like to speak to family members/ carers of adults who are using community-based mental health services. These include primary care (e.g. treatment and monitoring of a mental health condition by a GP), or secondary care mental health services (e.g. outpatient support from Crisis Resolution and Home Treatment team, or a Community Mental Health Team).

To take part, you must also be:

  • Over 18 years old.
  • Able to understand English sufficiently to take part in an interview or group discussion.
  • Able to provide informed consent.
  • Not currently using inpatient mental health services.

Who should I speak to if I am interested in taking part?

If you are interested in taking part, or would like more information, please contact Phoebe Averill at phoebe.averill@kcl.ac.uk.

Please note:

Carers will be offered a £15 shopping voucher in return for taking part.

Joint Southwark & Lambeth MH Carers forum June 2021

Welcome to June 2021 Joint Southwark & Lambeth mental health carer forum update. Below is a list of speakers for the carer forum.

  • Faith Smith – Unpaid carer on her 136 project
  • David Meyrick – Southwark inpatient carer lead updates on carer support.
  • Alice glover – SL&M Patient & carers involvement
  • Emily Holzhausen – Director of Policy and Public Affairs for Carers UK
  • Elinor Bradley – on gathering carer experiences for Royal College of Psychiatrist

Just a quick note that the Southwark & Lambeth carer’s forum runs once a month and seeks to help empower families and carers who are caring for someone suffering mental ill health. The idea is for families and carers to know what is going on and also to hold to account, while getting educated about unpaid carers, health and social care.

  • Faith Smith presentS ON 136 PROJECT

Faith who is one of the carers involved at SL&M (South London & Maudsley) involvement register, basically involvement scheme for patients and carers. Faith is also a member of several of my carer groups. Faith mentioned she is a carer advocate and is working on a new project that she would like to introduce to us this afternoon. The project is around the section 136 of the Mental Health Act. Section 136 of the Mental Health Act is actually a section that gives the police the power to remove a person from a public place when they appear to be suffering from a mental disorder to a place of safety.

The place of safety could be to a hospital or to police station. We all know that those those kinds of interactions do not always go well and the outcomes are not always what we would like. So she has been asked to set up and share what is going to be called a Pan London, section 136 carers board. The aim of the group is to establish a solution which a focus group of experts by experience, which would be a group of carers and service users experts by experience.

The idea is that the group focuses on coproduction, a safe environment, holistic approach, which would then in turn lead to better outcomes.

  • David Meyrick SL&M Southwark Inpatient carers lead.

Next to speak was David Meyrick who works hard to promote carer inclusion on inpatient wards. David wanted to speak about the carer champion roles and how that works on SL&M inpatient settings.

So across the trust, every team should have carer champion either either one or two, on the wards, and so that we have two champions for each team. The idea is that the kind of champion will lead on the work that team does for me and carers, but not in a way that they get left with all the work for carer support within that team.

What we want to do is encourage staff to create an environment where the whole team has carers on a focus for evidence business the same way that we approach safeguarding, for instance, safeguarding is ever in business.

What you want to do as carer champion is to be more trained, be more aware and have more case knowledge and skills around carers, but use that to support their colleagues so that we get a consistent level of support for carers. So currently we have two carer champions, each team has currently, in the inpatient setting, that can be a little bit of a challenge, because it’s a high turnover staff. David has been busy with carer welcome packs to give to families and carers on the wards and continuing with his carer support groups.

  • Alice Glover SL&M public and patient involvement

Alice wanted to talk a little bit about involvement. She wanted to be a little flexible on the issue of involvement because she not sure what members wanted to know regarding involvement and co-production. Alice was happy for anyone to put in questions in the Zoom chat or even interrupt her presentation.
Alice gave a quick overview of the involvement side of things. Alice covers Lambeth and Southwark, but for Croydon and Lewisham that is covered by Jane Lyons and other boroughs and directorates. Alice feels the whole thing about involvement is about how we’re improving and developing our mental health services, and how we’re improving people’s experience by people who use our services and people who care for them. The important thing is that as a mental health trust, we are listening to people’s experiences and those experiences are influencing changes within those services.

So there’s lots of ways that people are involved in terms of sharing their experiences from filling in satisfaction questionnaires, with specific questionnaires for carers. She knows David has done some really good work to encourage carers to fill in satisfaction questionnaires on the wards so that we can start to understand how carers are experiencing our services. Where it is not just about how their loved ones are experiencing things, but actually how carers also experience services.

As a mental health trust we look at complaints, and look at incidents and even compliments. So there are many ways of how we try and understand how carers are experiencing SL&M services, but also on behalf of their loved ones. Alice continued to explain other forms of involvement including the involvement register, which is basically a list of people who have been through a process and it is for people with lived experience of using our services, or as a family member or carer.

She is aware that there is at least 5 people at the forum who are on SL&M’s involvement, which they may want to say something about their experiences of being on the involvement register. Alice just wanted to say, they are always encouraging more carers to join our involved register, at the same time recognizing the limitations that people have on their time and totally understand that people don’t always have the availability just because of the other things going on in their life. Not least of which may be caring for their loved one.

The involvement register can be a flexible way of getting involved and being paid for your time. It means that you can you have opportunities to get involved in projects, sharing experiences as a carer in a way to try and influence change in terms of how services are developed.

  • Emily Holzhausen from Carers UK presents

Emily from Carers UK was delighted to be at such a carer-led forum and wanted to mention how she met Matthew quite a few years ago and I was so impressed with how he spoke about carer involvement at mental health trusts. She also wanted to mention how impressed she is with Matthew as he advocates for carers in regards to national work, because he really draws on the experience of working with unpaid carers and their stories. Emily enjoyed the discussions regarding mental health services and how unpaid carers experience involvement.

Emily has been around for many years campaigning on the unpaid carers movement, but she does wonder whether with some of the engagement and involvement is very well aware around the benefits issues with those payments. Emily wondered if it’s possible to be flexible around some of the expenses, for instance maybe paying for WiFi or data or something like that to help carers engage in a different way. If they can’t take the payment because of benefits.

Emily continued to speak about Carers Week 2021 and talked about why they campaign for Carers Week? They do it because caring is so often invisible, because it can quite often a private matter. The problem can also be a double edged sword because while its private, it can also mean carers can suffer in silence and isolation. So this year, it allows us to talk to anybody we want to really about caring, whether that’s the general public, families of friends, whether it’s employers, services and so on. So this year 2021, Carer’s UK chose the theme “visible and valued”, because last year, we said making caring visible, and carers told us we want a bit more than that. So such a theme added in.

Carer’s UK used their words and added invisible and valued this year. It has been really interesting as We’ve had a lot of engagement. Carer’s UK has done more events with employers than ever. Such events with employers and many more, but another thing is Carer’s UK had last year was tough for people because many are still getting to grips with the pandemic. So this year, there has been an increase in online activities with less being face to face.

Emily spoke about numerous wellbeing activities, which have been focused on carers, these were in terms of the politicians, where they had 66 MPs pledge support for carers week. Plus a number of MPs came to hear carer stories at one of Carers UK focus event.

  • Elinor Bradley on Royal College of psychiatrist project

Elinor attended the carers forum to speak on her latest project, she also works for Kent & Medway NHS trust, but she is representing the faculty of rehabilitation for the Royal College of psychiatrist. Elinor wanted to speak about a national issue, where she suppose it was similar to what Emily was talking about bringing the voice of carers forward. As of this moment the Royal college is sort of trying to represent the voices of carers and service users of rehabilitation services. She was sure many of those attending would know about mental health rehabilitation, but it’s really the branch of mental health services for people with complex mental health difficulties quite often psychosis. For those patients with psychosis, they have got some residual impairments, that really limit their ability to function independently. So quite often they unfortunately have had lots of repeated admissions, lots of crisis admissions, or lengthy admissions.

The royal college of psychiatrists have campaigned quite hard for the voices of people who have got complex mental health difficulties. This has sort of resulted in a new NICE guidelines, which are very sort of focused on reducing out of area care, and being focused on Person Centered Care, and also the involvement of carers and family as part of the support system.

So the RCPSYCH has done some really good work in the college, but what they are aware that they don’t really have the voices of carers or those other service users with lived experience represented on the website. So they currently engaged in a project and to collate some narratives or some stories of service users, for carers with lived experience of complex mental health.

The aim is to give those a platform nationally, so that would be on the Royal College of psychiatry website. Plus also to use experiences to work towards future campaigns and guidelines that we should be working towards. This is so that the royal college is looking for the good and the bad of supporting someone with complex mental health difficulties. This can also extend to the good and the bad of rehab services or even 136 assessments and inpatient wards as she mentioned on what David was talking about earlier on.

The aim is to raise the voices of the whole journey of supporting someone with complex mental health difficulties, so the college is looking for accounts, narratives of a range of people nationally.

This concludes June’s joint Southwark & Lambeth Mental Health carers forum.

Please check out our next set of carer group dates.

Please check out our next set of carer group dates.

Lewisham Mental Health Carers forum June 2021

Welcome to the June update of my Lewisham mental health carers forum. For the month of June my MP Janet Daby who attended to speak to unpaid carers and update us on what Lewisham has been doing for unpaid carers since carers week 2021.

Also in attendance was Jo Power who is the Liaison Officer for the Parliamentary and Health Service Ombudsman.

Cath Collins – Carer support worker presents on her role.

Before Janet spoke about unpaid carers, I felt it important that Cath Collins had a chance to speak about her role and her passion to support mental health carers. Cath Collins used to work for SL&M as a carers support officer, but is now employed by Lewisham council, but in a similar role.

Cath spoke about what she is employed to do and what she has been doing. Her remit is with the adult community mental health team. So she does not work with CAMHs, the children, adolescent teams, the older adults. She spoke about how we have primary mental health care teams in Lewisham, which is part of a new transformation of services, that should be aligned to GP practices.

Cath also spoke about having community teams where people have a longer period of support who suffer from serious long term mental health conditions. She mentioend we also have specialist teams in between, which are Early intervention services, which is for people in the first episode of psychosis, regardless of what age they are SL&M also have a personality disorder service.

Cath’s remit is to work with the teams to look at several things where one of them is to look at the information that they give to families and carers. These being are they getting the national up to date information? Other things focus on is such info good information about diagnosis? how to care for someone with a specific diagnosis? being involved in discussions around the care? If not, then why not? and how we could work on it?

With advice and information service, Cath reminded that they have got a group tonight, which is a mental health care support group where people can attend and speakers will go through important topics.

Janet Daby section.

I consider it very important MPs and those who lead on social care engage with those who are vulnerable in the community, especially if the group is grassroots and self-led. I am sure there are reasons why representatives would not want to speak to vulnerable groups, but those reasons are very few and far between.

It is also a two way thing, not only is it important for MPs to link with unpaid carers, but also unpaid carers understand the importance of forming relations. Too often I hear from unpaid carers that they are in an urgent situation and wish for counsel, which is fair. However I wonder in the back of my mind if something could have been done before things got out of control. It might be usually up to carers to keep their ears to the ground and find out what is really in store for them, even if they have the unpleasant task of trying to hold health and social care leaders to account.

Janet mentioned that Carers Week, which took place this year from 7 – 13 June, is an important opportunity to recognise, value and support unpaid carers. She felt that the Government must properly fund respite breaks so carers can put their own needs first, and ensure they can continue to provide vital, life-saving care and support. She knows that this is something that both Carers UK and the Association of Directors of Adult Social Services have been calling for.

Janet remains concerned that until there is long-term investment in social care, unpaid carers will continue to be overwhelmed. After a decade of cuts to local government, £8 billion has been lost from adult social care budgets and too many families have been left to cope without the support they need.

The Government first promised to publish its plans to reform social care over four years ago. Despite repeated promises, Ministers have still not brought forward any legislation, new funding, details, or timescales for reform. The recent Queen’s Speech, setting out the legislative agenda for the year ahead, was absent of any detailed plans.

Janet continued speaking to our group about being happy to attend and meet with us even if it was more than once a year. She spoke about her plans and concerns about the SL&M’s Ladywell unit and her plans to raise queries and questions with the chair of SL&M. I asked questions about Lewisham’s focus for carers and how those who lead on social care could engage with our group where Janet mentioned a few people. As a group we have been struggling to get engagement from those who lead on social care, but in other areas of London it seems easier to get that engagement, other carers have mentioned it is not worth the hassle, but I feel it is important to get such engagement even if they respond with bad news. Nothing is worse than being ignored and left to try and support others going through isolation, exhausting and feeling they are not being heard.

Jo Power Ombudsman presentation

Jo spoke about The Parliamentary and Health Service Ombudsman and the focus was on Who they are, what they do. Jo spoke about how the Ombudsman works and makes it’s decisions. Basically the PHSO was set up by Parliament to provide an independent and free complaint handling service. It is the final stage for complaints about the NHS in England.

The PHSO staff considers on the following.
– can they investigate?
– should they investigate?
Other factors include
Suitable complainant
Time limit
Legal remedy
Another organisation that could be involved.

Jo also spoke about how the PHSO gave’s evidence in the form of.
– Hearing from both sides
– opportunity to tell the PHSO what lay behind clinical decision making
– clinical records
– CCTV, phone records
– witness statements/visits/interviews

There was also an explanation about how the PHSO investigate complaints. As they look to see if what happened was in keeping with relevant regulations, standards, policies and guidance or established good practice. If it wasn’t, the PHSO look to see how significant the shortfall is and the impact that it has had and, if it has caused hardship or injustice, if that has that already been remedied by the organisation.

The PHSO also work with the following organisations.

Stats and figures were given for the carers group to digest from 2018/19

112,262 enquiries received
82,998 enquiries resolved through advice or re-direction

28,841 complaints handled by casework teams
24,183 complaints were not ready for us
5,658 decisions were made including:
746 investigations upheld
871 investigations not upheld
3,597 assessment decisions
444 resolutions

The PHSO also updated us on what they have been doing recently. As from last year they ran a public consultation to get people’s views on the draft NHS Complaint Standards. The consultation generated a lot of interest and feedback. On 24 March 2021 they published a report that set out the responses they received and explained what they did and the changes they made in response to the feedback.

There was a long Q&A session regarding the PHSO’s work and how the focus can be influenced by unpaid carers. This was the short update for my Lewisham’s mental health carers forum for June.

Greenwich Mental Health Carers forum June 2021

Here is a brief update of our Greenwich mental health carer forum for June 2021. This carer forum focuses on empowerment for mental health carer, while my Greenwich Mental Health carer peer group is on peer support and carer networking.

We were joined by MP Matthew Pennycook who is the Labour MP for Greenwich and Woolwich.

Matthew was mainly here to listen to unpaid mental health carers, which he could take up be it compliments or concerns. I could not go into any details but a few issues were raised one on the state of GP practices. We were also joined by Nosizo Magaya who is CQC’s lead inspector for Oxleas.

Matthew Pennycook MP for Greenwich

Nosizo spoke about what the CQC that being Care Quality Commission does and how they engage with NHS staff, patients and those who care for service users.

Nosizo reminded us that the CQC are a regulator, so they regulate all health services in England. She felt that perhaps the CQC could describe themselves as the Ofsted of health care. The only difference with the CQC and Ofsted is that they can prosecute, if they feel that there are providers that are not providing the adequate care.

So the CQC as an organization has got teams of inspectors that go in and review the care that’s been given to people. Sometimes they respond to whistleblowing, or any responses from any member of the public. Typically, if they do get a concern, they will contact the provider. If the person who gave the CQC the information is happy for them to share it. The CQC will contact the provider and ask for feedback and query what happened with this consent that has been raised. Their teams are a combination of different people on their health care professionals, anything from doctors to nurses, physiotherapists, and also some that are not healthcare professionals being expert by experience.

Nosizo also mentioned that they are based according to team, so the London mental health and community health service team would look after oxleas and she is the main contact for oxleas. Some queries from members were worried how long it would take to raise questions to the CQC, although another carer reminded that even if the CQC did not speak to a carer during inspection, it is always wise to raise a query off the CQC’s website.

You can check out more from the CQC off the site below.

https://www.cqc.org.uk/