Tag Archives: mental health

Joint Southwark & Lambeth MH Carers forum August 2020

Welcome to the august update of the Joint Lambeth & Southwark MH carers forum. This forum is run online due to covid-19 restrictions. The forum is aimed at those who are caring for someone with a mental illness. It is important carers understand what the mental health, health and local authority services has set aside for them and their loved ones.

For the month of August we were delighted to have John Lavelle the service director for Lambeth mental health services. We were also joined by Lee Roach who is the Head Occupational Therapist for Lambeth. In attendance were the carer members from both Southwark & Lambeth, Healthwatch Southwark and the chair of trustee’s from Southwark Carers.

The maim talking point for the August meeting was the Lambeth Hospital consultation. John spoke about how they want to improve the quality of the inpatient wards so that they can meet the most basic needs of the clients/patients. John stated that SLaM are committed to supporting people who are in distress because of their mental illness, they have an opportunity to build a new purpose, new mental health unit and SLaM are planning around how can they can make the service sustainable essentially for the future. I could certainly say most if not all members agreed with what John said.

It is well known that there has been number of periods of consultation for 12 weeks between March and May 2020. In the presentation to the forum from John, there were 2 options. Option 1 being that nothing is done about the state of Lambeth hospital or Option 2 where SLaM looks to relocate 4 acute wards and the Psychiatric Intensive Care Unit (PICU) to a new purpose-built facility on the Maudsley site, Denmark Hill.

There was another option to develop a new facility on the existing Lambeth Hospital site, but it failed to meet 2 key affordability tests.

These were that the option required additional capital of between £30 million and £35 million due to additonal infrastructure and loss of capital receipts, coupled with a need to decant at least one ward to the Bethlem and another to the Maudsley, causing significan disruption.

So eventually planning permission was granted in January 2020 by Southwark Council to replace the existing vacant Douglas Bennett House facility on the Maudsley Hospital site. It was also mentioned in John’s presentation that Service Users, Clinicians and Carers from a number of boroughs attended workshops to help shape the design so that a service user voice was present from the beginning of the design process.

The facility includes 72 acute beds for Lambeth patients across four 18 bedded wards. The wards will be single gender, compliant with modern standards and ventilated with direct unsupervised access to outside space. The facility will also include a Psychiatric intensive care unit and a rehabilitation ward designed to support the needs of these services.

Lastly two national specialist wards, neuropsychiatry and eating disorders will be transferred from the Bethlem Royal Hospital.

The carer forum were then showed their first visual of what one of the rooms would look like.

John Lavelle mentioned the mock ups are designed to give a with an idea what we think the rooms would look like. It is based on the drawings of that the architects came up with so the forum saw then would be things like flooring, textures and colors and even then those things might change.

John showed us what the dining space consisted of. He explained in the dining space there are two gentlemen sitting through the window and to the left is that kind of living space as you will see in the top left hand corner, one of our wards, current dining room on the London hospital site.

The carers forum were shown some figures in where

  • There were 235 responses regarding the consultation
  • 48 people participated in focus groups and public event
  • 148 responses in the online survey
  • 24 people then also commented on facebook
  • 171,189 were reached through the facebook adverts
  • 12 email responses regarding the consultation

One thing noted was even though SLaM had the intention to have some face to face meetings, they ended up having to move everything to virtual because of the COVID-19 issues. There also was a focus on making sure new services would target hard to reach communities especially those from BAME background who often would feel they were being let down or having to miss out on services.

Of the response to the proposals with about 84 % of responses were being being in favor of the change. Plus of that 64% were positive in the move of the wards to Maudsley.

SLam also did a specific work with a black male group around the consultation, and I found that there needs to be some further work to do around culturally appropriate inpatient clinical offer.

A good example was that one member of that particular group mentioned that the ward looks great, but actually, it’s what happens within that Ward is most important. So John mentioned in regards to BAME communities that maybe we arent getting it right for the moment. There is still a lot of work to do.

There will be a piece of work that is going to start in September, which is going to be supported by black thrive, which then will have SLaM think about what their offer is to black men as an example, when they are using patient services. This is work in progress, but SLaM are committed to that as part of the feedback from the consultation process.

John mentioned that they will be analyzing that the data that they got back done by the trust or by the CCG. And it’s just a bit of worth reminder that the consultation was actually a CCG consultation, because they are the people that ask slam on their behalf to provide the services to Lambeth. So the CCG led on the consultation and now SLaM’s healthcare consulting team is going to do the consultation and they have produced a report on the Lambeth’s Together website.

At the end of the presentation I stated it was an excellent presentation and it always helps when you’re describing something that seems really complex. This is one of the reasons for this forum is to get carers in the community and those who’s going to be affected by those changes to get at least an idea and get a chance to ask queries or comments or even compliments if you think this is something that’s really needed

Questions from the forum members

First to ask queries where representatives from Healthwatch Southwark.

Healthwatch felt it was really interesting to see and wondered if SLaM had like a Lamberth versus Southwark resident breakdown, because they were a bit concerned that maybe less people from Southwark had been heard from because the presentation was kind of titled as like improving services for Lambeth.

Another interesting query was on how wide the consultation going to be? as in numbers wide. A carer queried on is it just the local community because the impression they got from the report is its the local community. Plus it’s a Lambeth hospital and it should go to the whole Lambeth and and what does it now offer to the whole of Lambeth rather than the local area. The carer felt that it seems to present sort of housing project and, and and who’s going to administer that, for instance, who’s going to have The freehold at that particular site?

One other carer stated they came across the survey document in May, but they wasn’t aware then that the there was no provision being made for the Leo Ward and the early onset for psychosis Ward that is currently at Lambeth hospital. They felt according to the one of the therapists from the Leo community mental health team, which has been caring for the person they are looking after. That ward was the only early onset ward in the whole of the country.

The carer felt the ward was fit for purpose when their ‘loved one’ was there and the ward had an en suite bathroom. It was basic, but it was fine. It had an outside exercise area, and it was all on ground level. There was a separate male and female words with communal are. There were separate rooms for visitors to explore and visitors to meet a family members the carer felt that her ‘cared for’ had a good experience in that ward.

We also had another carer talk about their daughters experiences in those wards. The carers daugher did not go into Leo Ward and still the Carer did agree with what was said Leo was a good word. As the carer felt it gave both communal areas and it gave privacy for people as well and they had access to outside to meet each other in for games. The carer concluded that access to outside is important, and they don’t think that can be really possible in the tower block. On the other hand the carer agreed that the other wards are not fit for purpose at all. They’re dreadful!!

I mentioned it was good to hear that there is a push towards engaging the black community, particularly in the sense that certain things are just not quite getting there. I asked John that although he mentioned Black Thrive, I have noticed they are quite active in Lambeth. I continued to state that I’m not sure who’s the lead or use the contact for black thrive in Southwark, so I wondered who is contact overall regarding consultation under black thrive, be good to get their perspective in this forum.

Some contacts were mentioned, but also there might be at some point an opportunity for somebody to come and talk to us about the race equality framework standards that piece of work which essentially, is about assessing SLaM against some standards that have been set nationally.

Southwark Healthwatch mentioned in response to another carer’s concern about a blog they did. They had a previous presentation about the kind of safety of the ward and the architecture where someone asked a question, kind of related to what the carer was concerned about, which is shown below.

https://www.healthwatchsouthwark.org/blog/2020-04-30/whats-happening-lambeth-hospital-blog-southwark-mental-health-carers-forum

Conclusion

John finished up saying that they do have a communications and engagement group that was originally set up to think about the consultation processes and what material they might want to use and who they needs to engage with as part of the consultation processes.

SLaM are moving on the journey of the new build and providing samples and giving sign off really soon. So they will continue to think about how they can keep engaging with our communities in understanding what’s happening with the new build and what they are doing around whether it’s working with black men or whatever the different possibilities. SLam are going to keep engagement for the next few years.

Lambeth Lead for Occupational therapy presents

Lee Roach has been busy and presented a set of initatives regarding carers. Lee admitted that they have a particular challenge in the patient information system. Especially on recording information about carers.

So what they have decided to do in Lambeth is focus one week initially on carers as a is focused week. Lamberth are undertaking a number of different events during that week.

Lee thanked one of the carer members who’s agreed to come and talk to a couple of teams about her experiences as a carer.

When Lee was thinking about what what to do for those carer events, he really felt personally that the biggest impact on himself as a clinician is hearing the kind of narratives of people that his worked with and that usually has the biggest impact in terms of people reflecting on what they’re doing and so changing their practice. So in terms of hearing the experience of a carer, Lee think that’s quite an effective way of actually impacting change.

What Lee want to see as a result of the week’s events is a greater awareness of the resources that are available to carers that staff can refer people onto. Lee also wants to run a greater awareness of some of the resources that our staff can show carers on the wards. There also has been sign off of that they want more carers involved in the involvement register.

Breakdown of events

Lee spoke about the plan of the carer focused events. Where a carer agreed to talk to the to one of their teams on Monday so that’s the low intensity treatment team about her experience.

They are currently working across two sites. While they are working across a number of sites the majority the mental health teams are working on two sites. There will be another carer who will be talking to the team there about her experience on Tuesday afternoon.

The inpatient Lamberth inpatient care his group will meet virtually that started two weeks ago. Where they had 12 people attend that group. One of one of whom was was attending from another country. On Wednesday afternoon Lee is hosting a roundtable talk with possible Lambeth CCG, carers and Lambeth healthwatch. Then on thursday is the Leo ward community carers group. Then on Friday they are launching the ward lockers project from one of the involved carers who has been active inputting ideas.

This concludes the update for the August Joint Southwark & Lambeth MH carers forum. The September forum will have Kings College hospital feeding back updates on their Mental Health strategy.

Lewisham Mental Health Carers forum August 2020

133Welcome to the August update of the Lewisham Mental Health carer forum. This forum usually runs from the Carers Lewisham centre, but is now run online in order to avoid carers risking COVID-19 and taking it home to those they are caring for.

As a reminder the forum is an engagement, educational and empowerment group for those caring for someone with a mental illness. The mental health, health and local authority services are complex, ever changing and sometimes risks non-involvement or coproduction of carers and patients. The forum is a chance for carers to know what is happening in services and who is responsible for them.

South London & maudsley have been very supportive of the carer forums for over 5 years and counting. Still not only our local mental health trust engages with the forums. It now seems the Care Quality Commission is interested in grassroots forums.

The forum runs every last Tuesday of the month from 1 pm. For August we were joined by carers from other trusts including those in Greenwich and others from Southwest London. The carers were interested in how this forum runs and what they could take away from what was explained there.

Guest speakers were the CQC and also Lewisham’s Clinical Team Leader for mental health community services.

We started off by hearing from Susan George who is an inspector for the Care Quality Commission. Her main work is in inspecting GP practices. The CQC look at how they are complying with the regulations of the health and social care act, but also to look at the quality of care.

The inspectors from CQC recently visited my Lewisham BAME Mental Health carer forum and although they wanted more information on inspecting mental health services, it would be strange to say that GP practices were not involved. There is an extra twist, because the forums are carer forums the CQC are interested in how GPs are recording and identifying carers.

Quality-Care-Commission

So for August forum, the CQC were back to observe and engage with the forums closer than before. They are interested in becoming members.

Susan has been active for about two years and the look of the portfolio of GP practice in southeast London in Lewisham. Members are interested in the organisational structure of the CQC and what departments report to who and so on.

Susan continued by mentioning they want to improve their reporting on the quality of care provided by GPs for carers in the community. She feels there is definitely some work we can do together to try to improve the narrative in terms of how we report our findings in the area. She gave thanks to Natalie Parsons, who is a manager in the hospital’s Directorate at CQC.

The Lewisham Carers forum was also joined by SLaM’s involvement lead for Lewisham and Croydon. She also run’s the Lewisham advisory group that has raised several points for discussion with Lewisham health commissioners.

Susan mentioned that as an inspector she is particularly interested in the support that GP practices give their carers. It is vital for doctors and GP practices to identify patients who are carers, and that might include young carers as well.

She thinks it’s true to say that carers have certainly been affected by the change In the way that GPs are providing consultations, such as online consultations, and that, as an inspector, she is sort of looking closely at how access to these services change for people who may be vulnerable people with illness. This goes double for carers as well. It is a real challenge, because not everybody set up with online, facilities, internet and so on. Susan is also particularly interested as well around the space of health inequalities that have started to be talked about since COVID took hold, and particularly around the health inequalities in the BAME community. So it’s good for her to get to join your discussions in the forum.

GP Lewisham

Susan mentioned that one of the things we are trying to do is work across directorates. She feels forums like this one can help the CQC to share ideas about how they can improve and reporting on the quality of care for carers, especially when they go into GP practices, the CQC will expect to see their carer’s register. Plus the CQC will also want to see if the GPs are improving the number of carers that they’ve identified.

She thinks we do need to have more conversations within CQC. Natalie may have touched on this, and they are looking at how they can improve their our approach and methodology. So, at the moment, it’s still in the early stages. Still one of the areas has been identified on how the CQC can engage with providers to help to drive that improvement.

Questions from carer forum members

One carer was interested that the Care Act 2014 was released close to 6 years ago and feels change is not coming far enough. The carer feels that things have been going backwards due to cuts in services and local services. The carer asked Susan why are things taking so long?

Susan agreed in stating that it shouldnt have taken as long as it should. She does feel that there is real focus on it now. Its about the relationships the CQC can now build and listening to people like us and having frank conversations.

I did mention that to be fair, I do not think it’s completely the CQC’s fault, because there’s many other organizations including the local authorities. I mentioned that this forum struggles in getting a local voice because we can never find who or what is responsible for certain things.

Another carer was interested in how do the CQC capture carers feedback about the service they receive?

Susan responded that we do try to speak to people when we go on inspection and they pick up on information about how to feedback. There is also a chance to feedback on their website.

Susan mentioned that they also want GPs to publicize how carers can give feedback or leave feedback. So that we can also look at that on inspection. So the CQC will look to see whether GPs have got a system where they invite and asked feedback. If they have got posters in the waiting room, inviting carers to give feedback about the care and service they receive. The CQC can even also monitor phone calls and emails that we receive. So we’ll be looking at those quite closely.

gp-surgery

One carer member fedback on her experiences with her GP and how she experienced qualify of care for her and who she was looking after. The carer acknowledged that we all know the mental health is the Cinderella of the NHS. So you can see how many in all these directions that things are falling on the the unpaid carer. Susan agreed that the carer made a really good point about that sort of twofold awareness of the GP needs to have. The GP practice needs to have about not only identify with carers, but how is the carer is getting on with the person they care for

Another carer agreed that the online consultation for obvious reasons, was not going to be sufficient and a lot of people don’t know how to go online. Even if their GP sent them some information, it might not be always easy to access or to understand what the GP or drugstore have liaised with.

Susan agreed with the carers comment about how the lack of mental health focus on carers literature and leaflets. One of the things the CQC like to check when we go into the practice to inspect is that there’s lots of information for carers and that’s visible and perhaps using different languages. Susan from the CQC is also going to find out if they have an analytical team at CQC that helps to provide Some data for the next forum.

I mentioned that the way I see this forum is that carers can come together as almost as an empowerment. Besides since GPs are businesses anyway. So i would be interested to have like a list of GPs to have some rating in regards to how they are responding to carers. Plus how they engaged with them and what sort of initiatives are set aside for carers.

One more carer spoke about the difficultly she had when the surgery stated that she needed to bring her ‘cared for’ into surgery. Even though she escalated it and got through the practice manager, the surgery still insisted they couldn’t do anything due to confidentiality and this led to prescription issues.

Susan stated that they’re not allowed to ignore complaints and that they need to acknowledge your complaint within probably a couple of days, and they need to investigate it. Because when a patient complains, or when somebody complains to practice, it may well be that there are elements of how they provide a service that are actually falling short, and they’re not going to improve unless they investigate.

Susan raised an example of that learning can be shared with members of staff involved, and she felt you should definitely continue to raise that complaint to the GP practice and they should acknowledge your complaint and also give you a sort of timescale about how they’re going to investigate. The CQC always encourage people to complain directly.

General Manager for mental health in communities discussion

Stephenie Edwards introduced herself to the forum as the General Manager for communities. They are in the midst of and have been for some time of actually starting to transform some of their community services. Over the years Stephenie has been attending some of the carer forums, but she is retiring now. So it will be the last time that we actually see her at the forum.

Stephenie continued that they were starting on creating pilots last year and they have been going out to service users and carers just to actually gain some views and thoughts. One of the things that was brought up was around waiting times, for both clients and carers. What they have done is that they were changing around their front end about services, particularly in that where they were splitting their services into neighborhoods. They piloted the split initially from last March 2019 for neighborhood 1, and what used to be their assessment and liaison service where people can be referred by GPS, is actually now based within the Waldren GP centre in Depford, and so their nurses are Mental Health advisors, application specialist OT, social workers based on site.

stringio

Patients also go to other GP practices and they have what’s called a very quick triage. So GPs can request a service as soon as service users couldn’t be contacted if things were urgent within 24 to 48 hours.

Stephenie stated that they started in March two weeks into their pilot, but unfortunately they were hit with what the what the whole nation is dealing with the COVID-19 pandemic. This disrupted their systems and all of their plans. Still to some extent we were adaptive because they created groups to run from different sites and services, but at the moment, you can’t work face to face with people in group settings over time. To in some cases, online and the OTs are trying to work out other ways of working with service users that are face to face.

It was suggested by SLaM that the team launch another pilot for neighborhood three in Lewisham. Stephenie mentioned she was excited to say that she is going to meeting after this where they will be saying whether it’s safe or not to launch, neighborhood three. She anticipats it will be safe and start launching the day after the carers forum. The team have a new staff interface, that is a challenge to the launch. So what they have found Is that Deptford which is north of the borough is very different to South of the borough of Lewisham. One of the reasons is there are different communities there that they had to get to know in terms of meeting patients, but they are going around GP surgeries and asking if they can have some space to see people on GP sites.

Stephenie made a point that lots of people in the past, potentially felt stigmatized, by coming into community mental Health teams, we would have as much as possible we can see people just coming in for services within GP practices where you know, where where we can get, I think, any available space in GP surgery premium, but that’s what we’re hoping. And, and we have expanded or we’re in the process of psychological interventions for service users.

She feels this is a big thing because service users have told them for a long time that there needs to be more psychological intervention. And she thinks as it stands at the moment, we’ve increased our psychological retention by 15 new posts, however not all the people are in those posts at the moment, but they are recruiting to run the adverts are out. So there’ll be a lot more psychological intervention available.

That might be quite short term intervention or some longer term intervention, but it will be a standard model of care. So people will be assessed when they come in. And then from that assessment, it will be decided and agreed to what care plan and what an intervention would be best at that time for that person.

Traditionally, Stephenie’s team worked primarily with care coordinators who are managed care of a number of people, maybe 25 to 30 people. What she is having trouble with is actually recruiting nurses. And that’s been ongoing for the past four or five years. The thing is they have a number of vacant posts that they haven’t been able to recruit to repay agency costs equal to a higher premium. So when they have started to look nationwide, about how they can do things differently.

Questions from the carer members

One carer member was interested on who Stephenie’s successor would be. The CQC were also interested. Stephenie stated it was someone called Wendy Dewhirst she currently works in Southwark at their acute referral center. Wendy has worked for SLaM for a long time.

Another carer gave a suggestion that because one of the major things as people with mental health is, if they know this, their benefits is going to be stopped. It doesn’t take a genius to work out and it would send them spiraling. Some of them could end up being sectioned. That’s how bad things have got. Could you please have a specialist for PiP forms within the mental health team.

Stephenie explained that Bromley, Lewisham & Greenwich MIND are employed to help on this and they work with them. She mentioned they do a lot of work around benefits and are very skilled in it. They have also got vocational support staff and a lot of service users that they work with. Vocation workers themselves are absolutely experts in benefits, but the demand is so high that they can’t do that all themselves.

The carer replied that in the past a service couldn’t get help on benefit forms and that person just gave up. She knows it’s impacting mental health survivors and she knows this is going to have a knock on effect on service users which cause their mental health to deteriorate as well. Stephenie did admit that it’s going to get bigger with service users being furloughed maybe in October not having a job to go about, but she feels that’s where their vocation specialists will do all they can to help people retain their job.

Other carers are continuing the raise the matter of carer support workers, especially some years ago 2 SLaM carer support workers were lost and now no one has any understanding of carer support numbers. Stepehenie mentioned that a new carer support worker role will be introduced and mentioned this was a drive by Lisa Brian who heads adult social care in the borough. Denise O’brien is at the point of recruiting the carer support worker and they will be working with on strategy for carers in Lewisham. These adverts are going out either imminently or going out over the next four weeks. So it’ll probably take at least two to three months before carer support worker is actually in post. I requested that the advert also be sent to the group so carers can see what role the carer support worker will be employed for.

Another carer was interested in how community mental health services in the Borough of Lewisham were taking into account diversity issues of carers. Stephenie agreed that this should be a remit for all services across the country. She continued by stating Donna Heywood Sussex who is Lewisham’s Service Director has taken BAME issues very seriously and they are in the process of producing a BAME strategy. Plus they also have Leonie Down who is Lewisham Head of Occupational Therapy and Safeguarding Adults Lead working to engage the community and also get staff involved in the BAME strategy as well. She did state its worth asking Denise O’Brien to attend the forum to speak to carers about any carers strategy, but over the 5 years it has been difficult to get any insight into carer initatives in Lewisham and carers are wondering if there is co-production at a local authority level.

It was good news that the involvement lead will try again to get Denise to attend the forum and speak to carers about any initatives and we are really hoping things will be different this time. Lastly there was an update from Jane Lyons who is the involvement lead on getting patient systems to talk to each other. These being of patient records by with SLaM EPJs and GP patient systems.

This concludes the August update of the Lewisham MH carers forum. Next month 2 mental health trusts are to send their carer support leads to educate carers about the importance of carer peer support their carer peer support strategies.

Lewisham BAME MH Carer Forum July 2020

enteranceWelcome to the July update of the Lewisham BAME mental health carer forum. I’ve been doing this forum for many years now. As a reminder I run carer forums aimed at carers who are looking after those with mental health needs challenges or mental illness.

These forums are just a way for carers and families to get educated in regards to mental health services, or local author services. This forum is specifically aimed at those from the BAME community, the other carer forum I do is just more general mental health carers.

The BAM community have two specific set of issues Hence, the patients may end up using community servies, you know, high secure mental services. So that was the aim to sort of get them to have have an idea about the services created them, see what’s working see what isn’t working. For the July Lewisham BAME ME carer forum we have the Care Quality Comission (CQC) attending, plus regular carer members, along with Oxleas’s Community Development Service Manager and BAME Staff Network Chair. We also had in attendance SLaM’s peer support project lead and Damien Larkin who is a nurse who works at South London & Maudsley developing BETH the online patient health recording system.

The forum was also joined by Bromley, Lewisham and Greenwich mind Peer Project lead who offers support coaching up to £250 funding or people to set up peer support groups in their community. This is to help peers around mental health and well being, especially during this period of lockdown, but also beyond supporting people within the community around their well being and mental health.

Lastly the forum was also joined by Abby who works for lesbian refugee migrant network. They are one of the partners in the community well being service she is also the Community Engagement Manager delivering culturally mental health services.

Although the forum covers mainly Lewisham, we welcomed a member interested in BAME mental health groups and she is a Mental Health well being practitioner who also provides low level mental health support for children/young people under the ages of 25, vulnerable people going back into employment and business startups wanting mental health support.

CQC Presentation

To kick off the forum the CQC spoke about their role and answered questions. I invited the CQC down because I wanted carers and patients to develop more of a relationship with the CQC rather than the CQC engaging with users of services when inspections of services arises.

Quality-Care-Commission

Natalie Austin Parsons who works at the CQC meaning Care Quality Commission as an inspection manager spoke first as 2 CQC staff were present. Natalie was handed the role of engaging the forum because the previous CQC staff member Emma Mcfarlene only works in the directorate of adult social care, so they would inspect residential services for MH/LD/autism as well as nursing and residential homes and domiciliary care agencies. Emma suggested Natalie engage with us since Natalie works in the hospitals directorate who inspect in-patient and outpatient mental health services

Natalie was also joined by Susan Shamash who I have known for many year, were Susan attended my Lambeth Mental Health carers forum when they last inspected South London & Maudsley.

Natalie was kind enough to answer the previous queries I sent her before presenting to the forum.

The first question was on how does how does the CDC engage with slam? And how does it inspect and slam so

Basically they have a named inspector within the London mental health team. Plus they have a named inspection manager within the same team, that being herself. So we meet with senior staff within the trust regularly throughout the year, every two to three months. Face to face it was before COVID they generally would have those meetings at about 2 and or 1 and a half hours. The CQC would talk about previous action plans. So when the CQC came last time, they asked SLaM to improve this.

The CQC also get any kind of information or intelligence from absolutely anyone in the public who contacted them and if the CQC are concerned they will contact them immediately over email or phone.

The CQC use such information to see what’s going well, what are SLaM celebrating at the moment? What are SLaM working on that they they feel really proud of. And that’s really important to remember that there’s lots of things that could be improved in every trust, but there are also things that they’re doing a great and that’s how often the CQC tend to meet them face to face.

The CQC usually have contact with SLaM’s the director of nursing and director of quality. It’s only half an hour meeting every those every two weeks, but there’s a lot of turning in for information.

The CQC also have focus groups throughout the year if there particular errors or teams that the CQC haven’t heard from them for a while, or they want to hear what their improvements are while they’re doing well. The CQC will invite them to attend, but it can be really tricky, as Mental Health staff are really busy and realistically, who wants to go to a CQC focus group sometimes that’s not everyone’s first choice activity.

There will be some changes in how the CQC inspects SLaM due to a change in methodology. The CQC used to do a lot of engagement just prior to an inspection period, but now we’re looking at trying to spread that across the year rather than all in one concentrated amount.

The CQC respond to the first set of questions from Carer members 

The CQC gave the forum space to question them about their first response to my query. A carer member noticed a criteria that caused problems due to getting access to mental health services. The carer felt it meant that less people are getting services. Therefore, you could argue you’re going to get a better output because you’re dealing with a small amount of people getting access via MH service from their GP, which could lead to a false economy of patients quality of service within the mental health trust.

The CQC acknowledged the concern and stated it was a really important point. The CQC are always open and welcoming to any ideas. on how do you think that the CQC could do to help services improve.

The carer suggested sampling on how many people that got rejected for mental health services against those that was accepted. So to see within those within that range who they are, and then do a comparison, and see if there’s any within those samples of rejection and actually had similar cases.

The CQC noted that it was outside of what they would do for an inspection, however they are to happy to feed that back into their colleagues that go into GPS because the ones at this forum inspect mental health trusts only. This was a very important development as the forum is examining how GPs engage with mental health carers, especially if GPs are the first port of call for patients or carers during a mental health crisis.

Another question from a carer was about when the CQC come to South London & Maudsley how do they look for equality and diversity regarding carers? Because the carer has never seen you when the CQC show that in their report. The carer wanted to know if there is anything regarding carers, The carer also asked about queried that there’s never anything regarding carers or support on it. So how do you they show the quality regarding carers. This question was interesting since a mental health carer policy the Triangle of Care wanted the CQC to acredit such inspections regarding services to carers.

Again the CQC admitted that it doesn’t often come through in the reports very much even in the narrative. This is not only in slam but all the other mental health trusts, which the CQC will go away and report that to their team. The carer was also concerned about measurements of stigma and concluded that when it comes to mental health people have got stigma, especially the BAME community. If the BAME community can’t see anything from the CQCs report then they feel that you’re not interested. How can you be supporting us? If you’re not showing what you’re doing for us?

The third question from another carer member was a suggestion mentioning with regards to doing some measurements. Could the CQC not start with an existing data? Are they looking at historic data or working from the bottom as a starting point?

The CQC responded that this is something that they would do. The way they probably go about this is to have the mental health trust to do this. The CQC would ask the trust if they have the data? And if they don’t have the data, why do they not have the data? How do they analyze the data? And what are they doing with it? Have they made actions realizing that they could or couldn’t be doing something better? So certainly there’s work that the trust will have data that they can use to analyze this, but there may well be other areas that they could collect it.

The CQC present on my second query

The CQC responded to the forums questions and moved on the my second query I raised with them before they engaged with my BAME carer forum. The second query was on “How does the CQC engage with patients and carers during an inspection of a trust?”

The CQC presented that as standard when they come and visit a trust as large as slam, they divide services that it provides into something that the CQC would call core services. So examples would be adult inpatient wards. And slam have a number of those adult community mental health services, children, community mental health services, and substance misuse services if a trust provided. So those are examples would be wide across borders, and across all trust, and then the CQC write a final report for the core services.

There can be some difficulty if you are wanting to find out about a specific Ward or a specific team, and it can get quite lost in a report sometimes. if the CQC finds one Ward, or team that is doing particularly well or bad, then they will write about that in the report. But generally, across the trust this team, this type of service is doing well in this area or it could be improved in this area and then if the CQC need an improvement, they put it across the whole Trust.

Later on they inspect the trust about that improvement and in the report, the CQC have the five questions. So is it safe? Is it effective? Is it caring? Is it responsive and is it well led.

Experts by Experience

When the CQC come in with a team of inspectors, they are joined by professional advisors, who are currently working in that in that type of service in another range of interest. The CQC come in with experts by experience who have used that type of service themselves. The CQC do have people who are carers and who come in as the expert by experience as someone who is cared for a loved one with a mental health difficulty. Unfortunately the CQC don’t have many carers, the CQC have more people who have personal experience and the CQC would always welcome many more carriers to join that process as an expert by experience.

When the CQC come in they interview staff, they look at case records, they look at the environment, they interview service users. And the CQC do try to interview carers.

The CQC admitted that they think this is where they could do a lot better. The CQC request the contact details and the consent to be contacted by them through the trust, which the CQC think can be one of the barriers, they can’t just request a list of everyone’s names connected to services and then call them out of the blue. And so so that makes it a bit a bit trickier. Obviously, not everyone wants to speak to the CQC as well. Not everyone knows who the CQC are what they do. And that that again can be a barrier. The CQC collect all of that evidence and they make a judgement about specific things, you know, medicines appropriate training. So, that’s kind of an overview of how they do an inspection.

Inspection during COVID

Because of the COVID situation, the CQC are adapting the way they work at the moment. So they actually will give them longer time to spend talking to carers and people using services by telephone or maybe conferencing software.

The CQC then paused the presentation to give carer members a chance to raise questions on that subject. I won’t go into too much details about the questions, but they were very good regarding

1. How the CQC can gather patients and carers to hear abour services.
2. The problem of BAME carers worried about COVID-19 and how this will be captured in reports
3. More questions regarding sampling and data.

The CQC then presented on how well SLaM had performed during the last inspection and also responded on how well Oxleas has performed since Oxleas usually attend this BAME forum at times.

SLaM Peer Support lead presents

Next up we have the Peer support lead for the trust present on her role. Her focus at the moment is around making sure that we get more peer workers, working people, workers or people who have lived experience of mental health. And they are trying to make sure that we get peer workers working in all different departments of SLaM. This is so they can offer the lived experience and support people in navigating through the mental health service and navigating their way through recovery.

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SLaM have is what she mentions is a values based measurement, which means that they train peer workers to work to a set of values. Those values are the value of lived experience, developing safe and trusting relationships and strength based approach, anti racist, anti oppressive practice.

Training Peer workers

The peer lead continued that they train people and they do an eight week accredited training. They want to train people who have lived experience of mental health and who have used services. It’s really important to say that just because someone’s got lived experience, that doesn’t mean that they’re going to be good peer workers, you need experience to be a peer worker, and for having lived experience doesn’t make you a worker looking for loads of skills and qualities as well including communication, kindness, and the team working at able to support people with certain kind of recovery.

So what SLaM are looking at is a quite a wide skill set, so SLaM train people for eight weeks and then after that, they are working with teams to see where SLaM can have vacancies. At the moment, a lot of her work is trying to to transform their vacancies into pure workarounds. So maybe they’ve got a vacancy for a support worker, and see if we can transfer them to that team.

Carer members raise queries

There was a large number of questions from carer members one was on what support was given to Peer workers in such a demanding role. This being clinical supervision or regular support, support from line managers, etc, because there may be the sharing of quite challenging information

The peer support lead responded that peers get the same support as any member of staff and will have regular supervision with a line manager. Access, reflective practice, team meetings, whatever it is anyone else can do, but will also be put in regular supervisions that will be facilitated by someone who’s had experience of using their lived experience in the workplace, and which SLaM will ask all our new workers to do.

I also raised a query on why there is either a lack of carer peer supports or none at all, especially if service users get the majority of peer workers, peer befrienders, peer supporters. Carers are also using services, so where are all the peers?

It was noted by the peer lead that it has to be an evidence based initiative. So we need to have the evidence before they can start rolling it out. And at the moment, SLaM has evidence in regard to people with lived experience. So we know there’s loads of informal peer support that goes on for carers and meetings like this, but also just people getting to know one another. In her view, there probably will be. And I can’t imagine why wouldn’t work, with peers is supporting one another. Unfortunately at the moment it doesn’t look like SLaM going to follow that path.

Oxleas responded that they have a different view of carer peer workers than SLaM. Oxleas also have lived experienced practitioners who work in the trust and they have trained, experienced practitioners who have been carers, so they have broadened it so that includes anyone and the way that the roles and then people are employed as members of staff. their lived experience is an added extra. So you might be working in the board or in the health care system, but you are there with your lived experience, whether you’re a carer or a service user, and then that is the extra that you add to the role. Oxleas disagreed that carers were seperated from peer evidence based because how can NHS staff even begin to relate to carers?

There was a big discussion on the nature of peer support and on the peer support projects especially on the peer project regarding peer workers being placed in the Emergency department of Guys and St Thomas’s hospital.

There was also a very good question from another carer member regarding peer support and someone in a crisis, I think it went like this. As in terms of peer support, it’s relatively more needed when, when there’s a crisis, when a patient presents to an acute Ward, and this may be their first very first experience of the loved one, and experiencing mental health, rightly or wrongly, whatever the case may be, that is where that peer supporter is needed.

Plus we had several questions regarding if the involvement register was some form of peer support or if peer support was utilised across the involvement register.

The peer support lead did note that there is a problem on the way that the service works and particularly mental health services is that it’s not a very holistic approach. So one of the questions will be that the services not providing care for carers because that’s not their role. The MH services role is to provide care for service users. The problem is this, we know that if you support caregivers, then that’s going to have a beneficial impact on everyone including the service users. She admitted there needs to be a continued challenging of culture on how peer support works. It was mentioned to approach researchers regarding peer support at Kings college, but the Institute of Psychiatry, Psychology and Neuroscience was also mentioned.

The discussion went on for some time, but I think I have made this a very long blog post. This is the July’s update for the Lewisham BAME MH carers forum.

Joint Southwark & Lambeth MH Carers forum July 2020

Maudsley_Hospital_Main_BuildingWelcome to the July update of the MH carers forum.

The forum Encourages carers of those with mental health needs to get more engagement from services and to understand how mental health services work. Carers can also query them and compliment what they feel are going well. In attendance were Southwark Carers trustee, Lambeth carers hub mental health carer support. A few carers especially involved ones. The carer inpatient lead for Southwark and also the Carer lead and head of occupational service lead for Lambeth. The forum was also joined by staff and a governor from Guys and St Thomas to speak a bit about their mental health and carer’s strategy. We also had a young person demonstrate a new online application called “kooth”, aimed at young people.

Lee Roach from Lambeth Lambeth Hospital spoke about updates from Lambeth Hospital. He mentioned to the forum about staff who are carer champions over at the hospital. Staff work in a team effort, but not all of them are occupational therapist by background. Lee mentioned the different roles some of the staff do as some of them are running carers groups, some of them were maintaining carrier information boards.

Some events are being planned over at Lambeth hospital for carers. A recent event had a Junior psychiatrist, and occupational therapist and pharmacist talk to carers about questions that they had about medication and about diagnosis for their loved ones. Previously Lee wanted to establish a Carer champion in each of those six teams that were working out of the the Lambeth area. They made a little bit of progress and two or three members of staff were identified as carer champions with others who were keen to be involved.

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They even had a carer champion at community level, but unfortunately COVID-19 hit and services had to be put in lock down and what took place then was that the teams were reorganized and merged to cover services. Service leads were expecting a significant reduction in staff availability. So at the moment they are working to operational crisis levels.

Lee continued to state that for the 21st of August they plan to organize a meeting for carer champions. So they will get members of staff together alongside carers and aim to invite involvement from carers to update them on regarding the COVID period. The event will also share good practice and also to advise the new carer champions about what the expectations are for them.

The Lambeth hospital carer and services lead spoke how important that they make sure that the clinicians are thinking about carers and also to make sure that they are aware of all those people that are involved in that person’s life as much as possible.

It is also important that staff record carer’s details on SLaM’s patient record system so that should anything happen to the patient then the clinicians able to stay in contact with carers. Lee mentioned it is important carers are offered engagement and support plans for their needs, not just the need to services and talk about what some of the needs they might have.

Lee excitedly mentioned the that they are developing some exercise classes for carers. These exercise groups are being organized so that information can get to the clinicians and the carers in Lambeth as quickly as possible. On the 7th of September they are going to organize some events for the community mental health teams in Lambeth to raise the profile of carers and the needs of carers and I’m looking for volunteers and people who are on the involvement register. Lee felt the most effective way of communicating with clinicians about the needs of carers and the importance of involving carers, in the care of their loved ones, is for carers to tell their story and to hear that narrative of the carer’s experience.

The update impressed the chair of Southwark carers who was interested to know more about carer champions. I also raised the idea if Lambeth are looking to employ a Lambeth carers inpatient lead as for what Southwark have. I also wanted to know more about the role of Anna Penn-Carruthers who is a centre lead at Streatham living well centre, she was unable to attend the forum, but will come at a future date. I also wanted to know the situation with COVID-19 affecting Lambeth services.

For some time no carer is allowed on the Lambeth hospital site and that was the same for the Maudsley site as well. So no physical visits allowed. That’s now changed and carers are able to visit. But it needs to be by appointment now they have got rooms allocated on the Lambeth hospital site for the carer’s visits to take place. The thing is COVID-19 has made things much more restrictive. Lee feels the challenges for everyone over this period has been utilizing virtual meeting spaces and in how they are using the software mircrosoft teams. Things are moving back more to where they were before, but they are still very limited in terms of how staff visit people’s homes, organizing meetings and limiting the amount of unnecessary contact.

Kooth application

Next up for the Joint Southwark and Lambeth carer forum was Chanelle from XenZone to speak about Kooth which is an online mental wellbeing community. Kooth gives young people access to a community of peers and a team of experienced counsellors. Kooth is accessible for any young person who lives works or studies in Lambeth from the age of 10 to 26 years old.

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The good thing about Kooth is that it is free mental health support, but obviously not a replacement for the NHS or any mental health services. Kooth also has a link of different services that young people can contact when they’re in a crisis, which would be national services, because Kooth is not a crisis service is also something that people can use alongside with those those resources.

Shanelle showed us a quick video about Kooth, which can be seen from below.

Video of Kooth demonstation

After the video Shanelle explained what it’s like to sign up to kooth via a demonstration. She mentioned that when you sign up to kooth that it is very simple. So as shown in the video, it is an anonymous service. So they don’t ask people for their names or their address or anything that identifies them. Kooth only asks for basic demographic data that’s taken such as their gender, their ethnicity and age. And the reason they ask for their age is that they can make the content appropriate to the age of that young person.

Kooth has many different links where one of them allows a young person to look into the different counselors, as they can see different biographies about them about whatever they’ve chosen to speak about. Kooth is available in the boroughs of Lambeth, Greenwich, Bromely, Bexley and Southwark for the ages of 10 to 25.

Staff from both South London & Maudsley and Guys & St Thomas were interested to developing links to Kooth for referring to it as an additional resource.

Guys and St Thomas Carers Strategy

Next up were staff from Guys and St Thomas regarding their carer and mental health strategies. I feel part of the aim of this forum is to allow carers what services, policies and strategies are being done to aid in supporting their role. We were joined by Jackie Waghorn who is their new Mental Health lead for that trust taking over Caroline Sweeney. We were also joined by Sarah Allen who is the Head of Patient Experience at Guys and St Thomas talking about their carer’s strategy.

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Guys and St Thomas also sent Nikki who is one of the dementia, clinical nurse specialist on dementia and delirium services and they are inpatient based who their main role is to provide care and support to patients and their carers and staff within the inpatient settings. Nikki spoke about how they support patients by ensuring that staff carry out the principles of the St Johns campaign such as ensuring that flexible working, flexible plans are committed. Other things done are getting out carer surveys out to carers so that they can really understand that they have a voice and staff can understand what carers needs are. The staff normally carry out these carer’s surveys when carers come into the wards to visit their loved ones, and then staff can go through the survey with them. Otherwise, they send out carer surveys via posts and staff collect them.

Next to update the forum was Sarah Allen who is Hear fo Patient experience, she came to talk about the NHS trusts carer’s strategy and carer’s policies that are under review. There are 3 priorities so far which the trust will be looking to review.

1. Providing carer’s network days which are for local residents in Lambeth and Southwark, plus GSTT staff who may also be carers. The aim of these network days is to develop carer’s skills further in sort of key areas is what’s known as key skill stations. So sort of little mini sessions on different aspects of caring for someone. So that ranges from things like providing personal care and mouth care, to things like on dementia and delirium.

2. The other priority is they have a carer’s passport at the trust, but it’s not quite as well embedded as they would like. But really the role of that document is to support staff in understanding and recognizing the role of carers and the part they have to play in terms of the care and sort of providing information and understanding on the condition needs and preferences of the patient.

3. The final priority really is around for GSTT staff. This being that some of their staff are carers and is pretty much recognizing that their own staff do you have caring responsibilities as well often in addition to being parents, for example, that may also have young children that may also have a responsibility. They’re looking after an older parent or somebody else within their extended family or Friendship Circle.

The chair of Southwark carers was interested to hear more about Guys & St Thomas’s carers passport. She was also interested in the networking days.

Next we had Jackie Waghorn speak about her role as the the new mental health lead at Thomas’s. Jackie has been in post for six weeks, so is pretty new and still trying to find her feet in the organization.

st thomas

She has has come from Croydon, where she was doing a very similar role running health services. Prior to that. she worked in offices and mental health trust for many years, managing crisis and mental health services and working in crisis and mental health services.

Guys and St Thomas Mental Health Strategy

Jackie spoke more about GSTT mental health strategy which was launced on Mental Health Day and the strategy lasts up till October 2022. In developing the strategy, this strategy was devised by her predecessor, Caroline Sweeney. And in devising this strategy, she did consult with a number of different stakeholders, including patients and carers. Jackie was not sure what any of the forum members were involved in that.

What the strategy does and in, in supporting carers is not quite specific, becaue it’s basically divided up into three sections which are patients, people and partnerships. And it really is just thinking about how they can involve carers and how they can support carers in each different section. Jackie is looking to basically develop a group which would oversee policies and things to make sure that mental health is considered in everything that GSTT do. Next we heard from Georgie Smith who has recently recruited into a new role which is Mental Health Improvement lead.

Her role is and the work that I’ll be doing is is carrying out several projects under the name of Lilly Sterner, who was a patient who left a legacy. In those projects she will focus around improving mental health awareness and improving mental health delivery within the trust of guys and St Thomas. Then Paula one of the governors from Guys and St Thomas NHS Trust. She was interested to hear if there was enough support within the community for mental health and also onthe strategies that the trust will be administering?

I was interested in how the trust engages with patients and the public and if there were staff at guys who has a focus on carers. Sarah mentioned that they try quite hard to actually involve patients and carers in sort of the redesign of pathways and redesign of services. This is done via the patient and public engagement team. It was also mentioned that there has been a number of staff trained up to become what’s known as mind and body champions, the Mind Body Program from kings health partnerships, has done a lot of training for keep just staff focused mental health awareness. So they have mental health champions and obviously part of mental health is care awareness. It will be good to see if GSTT can work with the joint Lambeth and Southwark MH carers forum as their new Mental Health lead continues her role, as the forum aims to raise the profile of mental health carers.

Southwark inpatient carers lead update

The last update was from David Meyrick who is the Southwark carers lead for inpatient wards. David reported that all the Southwark Wards are open, were wards that were moved to other boroughs are now back in Southwark. There is other good news that the carer champion roles are becoming more relevant and active. SLaM have also just finished a project on one of the Wards listening in action project. This has been a project to make the ward more family friendly. There has also been an improvement to the waiting area the visiting area.

The waiting room has been redesigned search cordoned off to give a bit more privacy and social distancing plus two families can to visit at once rather than a portable partition so it’s a bit more than welcoming and relaxing area and and also a lot of work on the leaflets and literature produced for carers and help make it more informative and more family friendly from that perspective.

We also had an update from carer peer supporter Annette on how she is co-facilitating carer support groups online and how the peer support role empowers her to support families and carers.

Caring through stigma

 

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Hello fellow carers. Every so often during writing blogs off my carer forums, I tend to write about the carer experience. In this particular blog I want to write about stigma and make unpaid carers aware of what stigma is and the damage it can do.

Just to make things clear that when I talk about carers, I am not talking about NHS workers or nurses. I am talking about people who care for someone severely unwell in the family, or perhaps caring for a close friend. I am not saying that some in the NHS are not caring for someone in the family, but I want to cast the net out and bring in those whose identity is blurred away.

This blog site focuses a lot on mental health carers, so I do not want to stray too far from them. As a reminder a mental health carer is someone looking after a person with mental health needs. This could be a form of psychosis, bipolar, depression, Post-traumatic stress, OCD and so on.

Depressed woman sitting on stairs

Unfortunately with mental illness, stigma does strike at the heart of those affected. The stigma can affect both carer and ‘cared for’. Many may ask what is stigma?

The Shame

It does not take long to google the word ‘stigma’ and see it linked to mental illness. Stigma can involve many things, but often stigma is linked to mental illness.

Basically stigma is Fear and anxiety about a disease that can lead to negative attitudes and beliefs toward a person and their characteristics. This can be down to others not understanding mental illness be it a lack of education, awareness, fear or worst of all ridicule. With MH stigma, suffers of mental illness begin to lose friends, family support and can be ostracized from the community.

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The stigma often can hit the sufferers family and close relationships. Some in the family may stay clear from the situation leaving the most concerned to take on the carer role. Some in that family might even actively practice stigma and even then the sufferer of the illness might be stigmatised through their own illness as they will not engage with health and social care services.

Unfortunately it can be that the mental illness itself can blur how the sufferer understands what is effecting them. It is as if the mental illness makes it harder for the person to come to terms with what they are going through.

When I was caring for my mother, I noticed over the years how many friends withered away, even some neighbours kept their distance. I myself experienced a lot of stigma as some laughed at me when they realised I was caring for someone with mental illness. During the early years my mother became sectioned often as she struggled to cope with medication and support. Many would see her taking to the hospital by the police or ambulance and would gossip.

The continued experiences of watching my mother go through the rotating door of the mental health inpatient ward took its toll and I got tired of trying to educate and explain to others on reducing negative views. At one point, even I kept away from my mother as she took out her frustrations on me.

With no where to turn, I withdrew into myself and battled stress, depression and anxiety and mental illness can be catching. With a strong carer focus, I managed to look after myself and spare enough energy to continue to look after my mother.

Would not have it any other way

Looking back at it, I can be proud as I would often hear many let that stigma drive away those close to them. I stood by my mother until the very end as a son should do, although I am aware that not all carers can do this and there is no shame in walking away, because sometimes health and social care cannot provide that support.

There was always a risk that the stigma and lack of support would push me to becoming the next mental health patient, but I had to be strong. I had to keep working to help in bills, providing care and support, holding the family together and setting an example to fellow MH carers.

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I will not lie, the experience of care has worn me down and I do not get too close to others. There are some things I cannot explain as yet because it will bring painful memories to the surface. I can say this though that time and patience does help.

If I had to go through it all again, I probably would and I most likely would have done quite a few things differently.

There is no shame

As an educational part of this blog post, I would like to mention there is no shame in caring for someone with mental illness. It does of course depend how unwell they are and you as a carer will need support. It is advisable get as much support from health services, friends and family.

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You of course will have to be strong when stigma comes your way, many just do not understand. Many do not realize that mental illness is very common as we all suffer from anxiety, stress, anger and depression. It does not take long to notice that a tip over the edge can lead the sufferer to severe mental illness.

I certainly have more patience with those who have mental illness and refuse to laugh and joke when I see someone in the street battling the illness. It can happen to any of us or those we are close to. There is no shame in mental illness and with the corona virus epidemic, society will have to get used to mental health because there will be a lot more to deal with.

Joint Southwark & Lambeth MH Carers forum June 2020

Maudsley_Hospital_Main_BuildingWelcome to the month of June joint Southwark and Lambeth MH carers forum.  I usually run this forum at the Maudsley hospital. As a reminder the carer forums are aimed at carers who care for someone with a mental health need. I run around 5 carer groups each month and most of the groups work towards engagement, co-production, involvement, education and querying about mental health and social care services.

The Joint Southwark and Lambeth carers forum runs online due to the corona virus. Carers from either Southwark or Lambeth will need a free application called Zoom either on their computer, laptop or mobile phone to attend the meeting.

For the June meeting we were Joined by Southwark Healthwatch, Lambeth Healthwatch, Lewisham Healthwatch and also Greenwich Healthwatch where they traded ideas about carer projects. We were also joined by the trustees of Southwark Carers, Southwark impatient carer lead and also a carer who is a carer peer supporter. Both SLaM Southwark and Lambeth advisory group carer members attended and we were also jointed by Cllr Jasmine Ali who is Southwark Council’s Cabinet Member for Children, Schools and Adult Care. In attendance was Cllr Danial Adilypour who is the Lambeth Cabinet Member for Health and Social Care and Finally the main speaker to engage with carers is MP Helen Hayes.

Coming off the back of carers week, the forum was interested to hear what Southwark and Lambeth council had been doing for carers in both boroughs. First we heard from Southwark Healthwatch from all the work they have been doing to highlight the situation unpaid carers face in the borough.

Southwark Healthwatch update on carers

Southwark Healthwatch spoke about listening to peoples experiences of health and social care and trying to make change to the wider community. Over the years Southwark Healthwatch spoke about the priority areas and one of them being unpaid carers. In 2019 their project on unpaid carers looked at surveys, focus groups and interviews with carers.

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Results of the project looked at the daily life of carers with themes being on qualitative experiences. The project looked looked at the Impact of caring, which was reported to be very extensive, emotional and intense.

Other findings were

  • Carers felt they were going on beyond the roles of caring – especially on care coordination.
  • It was noted some carers were doing 69 hrs of unpaid care each week.
  • Stress levels, tiredness a strain on carers Mental Health.
  • Financial situation under strain due to multiple levels of care.

Southwark Healthwatch looked at the support carers were getting through social care services, this became an additional challenge for carers due to chasing people on the phone. Bureaucracy led to isolation of carers. Carers reported back that interaction with social workers or GP was not always a positive about the experience. Many felt the levels of service was inconsistent, lacking support and empathy, which led to distrust of council provision.

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Carers did value one off support for benefits applications, carer assessments. Carers also felt activity groups were useful along with respite, but must be flexible. Counselling was hugely important for carers.

Carer members at the forum queried carer counselling services either from Southwark Carers, SLaM or Southwark council.

Southwark HW are going to raise this at Southwark Council’s “Carers Board”, hopefully the forum will get some feedback on this. The forum is worried about funding and accessiblity of counselling since Southwark carers lost their counselling service due to funding.

greenwich healthwatch

Greenwich Healthwatch fed back that on young carers awareness day they visited some schools and wrote a report on the experience of young carers, they felt that young carers are not heard in the borough and will be learning from others on what could be needed.

MP Helen Hayes engagement with forum

Helen gave overview of issues raised from when she the last attend our forum back in November 2019 . Helen updated the forum on how COVID-19 affected both Southwark and Lambeth boroughs. She noted that COVID-19 has shone a spotlight on inequalities in Health and social care. Corona virus has impacted the community’s mental health due to lose of income and difficulties accessing food and medicine. Helen’s email inbox is hitting over 1000 emails a week due to the coronavirus alone

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MP Helen Hayes

She wants to take back views of Mental Health carers back to parliament and spoke how one of Labour’s previous election pledges was on increase of carer allowance. There is also a focus on the need for paid leave for carers, which they will continue to work on.

Helen spoke on how Carers assessments under carers act and how the Care Act a welcome reform, but was not supported by levels of funding. Helen mentioned that she is the Co-Chair of the All Party Parliament Group on Adult Social Care and they were working hard to reduce the fragmentation of the care sector.

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She stressed that both Southwark and Lambeth council have been working very hard to address those needs and although she has been MP for Dulwich and Norwood for 5 years, she felt that MH issues will rise due to the problems corona virus has impacted on the communities.

The forum raised the issue of care homes especially the problem of how COVID impacted them as many carers have loved ones in support housing or care homes.

I also asked Helen about involvement for carers at the highest levels, where Helen phrased the importance of “Nothing about me without me”. She agrees that those who are expert by experience should be involved in policy or carers be allowed to co-design and co-produce.

Update from Cllr Jasmine Ali on Southwark Council commitment to carers

Jasmine thanked Helen Hayes for her support when COVID caused so much distress in the borough of Southwark.

Cllr Jasmine Ali

Cllr Jasmine Ali

Jasmine was not a fan of the work Matt Hancock has done so far, but at least we are slowly getting in a better place. Jasmine noted that adult social care and carers are a big priority in the borough. She reported that there are around 26,000 carers in Soutwark alone, but she was proud of the work that Southwark’s Wellbeing hub, Southwark carers and older peoples hub were doing. Jasmine talked to the forum about Southwark’s future plans and that there will be a strong emphasis on advocacy, guidence and signposting.

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She spoke about the importance of SLaM’s recovery college and how a focus needs to look at increasing the caring relationship between cared for and carer. There are plans to Link carers with Universal services e.g. public health, learning and leisure and the developing work on Southwark’s Carers joint strategy, need assessments and the carers pathway board. She wanted to hear what are issues being raised from the forum.

Jasmine spoke on the importance and need for the Ethical care charter and carers charter, although a lot of work has stopped she fedback that by the end of June things will start up again.

Update from Cllr Danial Adilypour on Lambeth Council’s commitment to carers

Danial agreed with what both speakers raised at the forum and mentioned carers are a very important issue in the borough of Lambeth. There are big pieces of work from the boroughs “carers card” scheme which came out of Lambeth Carers Strategy. First part of the launch was actually off carers week 2020. The Second part of the ‘carers card’ launch will be at the end of the year, where businesses will provide a range of discounts to carers.

Cllr Danial Adilypour

Cllr Danial Adilypour

Daniel gave out stats and showed there are around 20,000 carers in Lambeth. He mentioned that the Lambeth carers card is not the end of what is being offered off Lambeth Carers strategy, there will be more to come.

Currently there is a helpline open during the corona crisis. Lambeth council will work on several strands being.

  • A&E services (the problem of people not accessing services due to MH), but will work with Lambeth’s ‘Living well network alliance’ to increase access to A&E.
  • The problem of Social isolation is another strand Lambeth is going to work on where they will develop a strategy.
  • Lastly Daniel stated that Mental Health will hit Lambeth due to the COVID situation, Lambeth will continue to engage with groups on this topic, especially the MH carers forum.

Carers from the forum were queried Cllr Danial regarding the SLaMs Lambeth hospital consultation. There will be wider plans over the coming years involved with Lambeth carers strategy to engage with forum.

Healthwatch Lambeth Update

The forum was joined by Lambeth’s Healthwatch Natalia Sali​​​​​​ who is their Engagement Manager. She Updated us on the 80 page report of Lambeth Hospital consultation recommendations.

lambeth healthwatch

She reported that over the month carers were fearful of using services. So because of this, Lambeth Healthwatch put on an webinar event where Speakers from Kings college hospital and a GP from a surgery presented what services are available for users.

Consultations are online at least and Lambeth HW will expect changes to face to face appointments, but this depends on virus

Lambeth Healthwatch will continue to speak to carers, older adults and young people regarding experiences in care packages during pandemic. As of this moment Lambeth HW are runing webinar’s every 2 weeks, the latest one on pregnancy, which did interest a member of the forum.

Updates from SLaM and forum carer members

David Meyrick SLaM’s carer inpatient rep fed back on how SLaM’s wards were

  • Allowing visitors back on ward, but visitors need to respect social distancing.
  • Developing a ‘missing in action’ project on female wards.
  • Looking into wards becoming more family friendly during visiting hours.
  • Carers strategy is in a draft.
  • Webinar course at SLaM recovery in July.
  • How the Peer support groups were continuing to run online.

The SLaM carer peer support runs every Wednesday from 6 till 7 online, where the carer peer support updated the forum on how the carers group was getting along.

We also had Updates from Southwark Advisory group members on

  • Producing a video for SLaM website on what Service user involvement does
  • What can be learnt from COVID-19
  • Qualification courses for patients

Updates from Lambeth Advisory group

  • Richie QI peer lead asked the group on what patients expect from services
  • Met with the Head of Lambeth Alliance chair on regarding how their Covid-19 strategy would be developing.

This concludes the update for June.

Lewisham MH Carers forum June 2020

133Welcome to the June update of the Lewisham mental health carers forum. A forum aimed at unpaid carers supporting someone close who has a mental illness. This is one of the 4 carer groups that I run per month. In attendance were our usual carer members along with representatives from Lewisham Healthwatch. The speakers from South London & Maudsley NHS trust being psychiatric Liaison staff and the lead from SLaM Patient Advice Liaison service. We were also joined by SLaMs involvement lead for Lewisham and Croydon, plus we were also joined by the Mental Health Lead of Lewisham and Greenwich Hospital trust.

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Lewisham BAME MH Carer Forum May 2020

enteranceWelcome to the May update of my Lewisham BAME mental health carers forum. This is one of my 5 carer groups that focuses on the experiences of BAME carers and sometimes BAME groups suffering mental ill health.  I usually run this forum from the Lewisham Branch of Bromley, Lewisham & Greenwich MIND.  Due to CoronaVirus I have moved the forum online via ZOOM.

As a reminder the forum is not a support group, but a way to connect to health providers in the community. The forums focus is of course on mental health services so our local mental health trust (South London and Maudsley) engages with BAME families and carers at the forum.

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Beyond Carers Week 2020

smallerHello everyone and fellow carers. Just a quick blog post now that Carers Week has ended. For those who do not know about Carers Week, basically it is an awareness event that looks to raise the awareness of unpaid carers throughout the week of June 8th – 14th.

Carers Week is an annual awareness campaign to celebrate and recognise the vital contribution made by the UK’s 6.5 million carers.

My view on how Carers Week 2020 went

I am not sure if many people or blogs mention views on post events. I felt Carers Week 2020 really raised the bar for Carers week 2021 due to the amount of activities, events and awareness drives from people, charities and organisations. I have been involved in quite a few carer awareness events over that week.

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Lewisham MH Carers forum May 2020

Welcome to the month of May’s update of the Lewisham Mental Health Carer forum. This is one of the 5 carer groups I run once a month to give carers a chance to find out what is happening to health, mental health and local authority services aimed at carers.

For this month we were joined by South London and Maudsley’s Associate Medical Director Dr Zain Sadiq who is also a psychiatrist. We were also joined by Lewisam’s Wellbeing Map coordinator Tim Bradley. At the forum we had a number of carers as well as carer champions, the modern matron from SLaM’s Ladywell inpatient wards. We also had in attendance the SLaM involvement lead for Lewisham and Croydon as well as Carers Lewisham staff and a representative from POhWER mental health advocacy.

I explained the reasons for the forum being the following.

1. It can be difficult for Carers in Lewisham have an idea on MH services and influencing them.
2. MH carers need some empowerment in their role.
3. Services have suffered from cuts, carers need to act in order to support everyone.
4. There needs to be an engagement platform for carers to discuss issues.

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