Welcome to a brief update of my Lewisham Mental Health carer forum for October 2021. I know I am behind in updating people about my carer forums, but I have mainly been busy working on my 2nd book. I am glad to say the book “Experiencing mental health caregiving – unpaid carers” has been published and can be bought on Amazon.

For the October carers forum, the following speakers were

• Martin Crow – Business Manager – Lewisham Safeguarding Adults Board
• Cath collins (carer support officer) – Triangle of care
• Eunice Adeshokan (Matron Acute Inpatient Services) – Carer engagement at Ladywell Unit

I also was going to do an online carer’s quiz for members, but only if there was enough time during the forum, plus I have to run my Greenwich MH carers peer group after the Lewisham mental health carers forum.

Martin Crow – Business Manager presents on Lewisham Safeguarding

Martin Crow sits on the board for the borough of Lewisham Safeguarding. The Lewisham safeguarding board was established statutorily in April 2015, to meet the requirements of the Care Act 2014. Although Lewisham had a safeguarding board in Lewisham, for many years before the Care Act, it was put on a statutory footing for the first time in 2015. The board has the responsibility for setting the strategic direction of Adult Safeguarding cross the borough of Lewisham, and is made up from over 20 organizations. But the three statutory partners are the police, Lewisham council and the clinical commissioning group southeast London CCG. So the key public sector partners, as well as other voluntary and community sector partners are involved in the safeguarding board. In the end it is their job basically to oversee the approach that the safeguarding board have, collectively, to ensure that adults are at risk of abuse, neglect are supported and protected in the best possible way.

Martin feels the key thing is that safeguarding is everyone’s business. So it’s not just about those 20 organizations, it’s about any organization that delivers services to adults at risk. It’s about adults themselves, and it’s very much about carers as well and not just the patient or service user. So the job of the board is to engage a very wide range of people from different communities across the border. This is so we can all help to play a part in protecting those most at risk. So part of Martin’s job is to is to help to reach out to different communities, organizations and work closely with them and in partnership with them.

Martin gave us an overview of what Adult Safeguarding actually is and about the word safeguarding can be used in many different ways and in many different contexts. For the broadest possible way really to think about Adult Safeguarding is that it’s about people. It’s about organisations and it’s about working together to prevent and stop off the risks and experience of abuse and neglect. So it’s not just about thinking about when things have gone wrong.

Martin mentioned that when people have experienced abuse, it’s thinking about the risk of abuse. It’s very much about prevention. so when the Care Act came into force in 2015, prevention really was really brought to the forefront because in Adult Safeguarding terms prior to that, there was too much focus really on protection about when something had already happened (which meant it was too late). The intention of the care act was to turn that around to say that there should be more focus on prevention.

What Martin was seeing around safeguarding is that it is everyone’s responsibility. The only way that people can hope to achieve those things in terms of prevention and stop the risk of abuse is by working with the whole community approach.

In Lewisham Martin mentioned that we have many organizations that run specific services, there’s probably over 500 organizations in Lewisham delivering services that can be a risk.

Martin spent quite a while talking to carer members about the types of safeguarding abuse and what the causes would be.

Cath Collins presents on SLaM NHS triangle of care

Cath Collins is Lewisham council’s carers support officer who works closely with South London & Maudsley’s NHS foundation trust. She was here to present and raise more awareness of the triangle of care and how it can be used for mental health services in the borough. Cath asked members what they knew about the ladywell unit, which is SLaM’s inpatient psychiatric ward and part of Lewisham Hospital. This is where anybody who needs to go into hospital suffering a mental health crisis could use in terms of going into a mental health Ward.

Cath mentioned that the triangle of care has been around for at least over 10 years, possibly longer. It’s a form of excellent practice when working with carers and families or in a mental health setting. For South London & Maudsley they are going to focus on the wards initially because that’s where when the triangle of care was formed, that was its first focus, it was put together by a carer Alan Worthington.

Alan developed a good practice guide on the back of his own experience while visiting his son in hospital. So the practice actually comes from a carer’s perspective, which has expanded to around 50 Mental Health trusts in England that have signed up to it.

Cath talked about the problems of not using the triangle of care, which provided the following challenges.

• Carers being excluded at certain points of the care pathway
• Failure to share information on risk assessment and care planning (see SUI reports and recommendations)
• Requests by carers for information, support and advice not heard
• Carers unique and expert views and history of the service user can be missed

She then mentioned some of the benefits when the Triangle of care is implemented for mental health services.

• Clarity over matters of disclosure from service user to carer
• Increase in identification of carers and referrals to carer support services
• Increase in communication from more carers attending care planning meetings and ward rounds
• Reduction in complaints and increase in compliments
• Increased enthusiasm from staff

The triangle of care requests strict self assessment from wards, staff and community settings, this goes to insure things are implemented correctly and this helps staff recognise what key areas are needed for improvement.

Eunice Adeshokan presents on Carer engagement at Ladywell Unit

Eunice who I have known a very long time stepped in to co-present on carer’s awareness training at the inpatient ward. She mentioned that carers awareness training on a system has been done via an online system for staff. It’s about no less than an hour training, but a lot of work needs to be done to improve training. So one of the plans that SLaM has got in mind is to make sure that know their staff are carer aware and encouraged to complete this training and more.

Eunice talked about how they currently engage families and carers on the inpatient wards and what challenges have been taken up. Eunice will be back in January 2022 to talk about their event regarding triangle of care and serious incidents, which I have been involved in developing.

This concludes my carers mental health forum for the borough of Lewisham