Tag Archives: NHS

Triangle of care – Excellent NHS carer engagement

10177241_747738765268892_5890142387668348507_nIt has been a while since I blogged off my site, almost a month now. Still I have been very busy, lots going on and still lots to do. I run 4 carer forums each month and am also an unpaid carer working part time and contributing to so much in the community.

Yet I am aware many unpaid carers supporting those with mental health needs cannot easily engage with services. This is one of the many reasons why I chose to write this post. I am an unpaid mental health carer in south london, and have been involved with the Triangle of Care at a high level. Due to the involvement I am proud to be part of such a successful initiative. My trust has not been part of the Triangle of Care scheme even though I battle on, but it has got me wondering.

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What would it be like to be a carer whose NHS Trust is part of the Triangle of Care scheme?

If you do not know about the Triangle of Care policy, let me enlighten you.

Taken from the Carers Trust website, which is national charity fighting for the rights of young carers and carers alike.

“The Triangle of Care guide was launched in July 2010 by The Princess Royal Trust for Carers (now Carers Trust) and the National Mental Health Development Unit to highlight the need for better involvement of carers and families in the care planning and treatment of people with mental ill-health.”

Many Mental health NHS trusts up and down the country have taken the challenge and value the needs not only of their patients/service users, but also unpaid carers who often can be forgotten in Trust Policy, let alone in government policy.

The triangle of care gives six standards

1) Carers and the essential role they play are identified at first contact or as soon as possible thereafter.
2) Staff are ‘carer aware’ and trained in carer engagement strategies.
3) Policy and practice protocols re: confidentiality and sharing information, are in place.
4) Defined post(s) responsible for carers are in place.
5) A carer introduction to the service and staff is available, with a relevant range of information across the care pathway.
6) A range of carer support services is available.

I have mentioned such standards because there is a lot more to the Triangle of Care, but if you are not versed in policy then at least focus on the standards above.

So what could it be like being a carer linked to ToC?

If you are a carer whose mental health trust has signed or is working towards the triangle of care, I will list why it perhaps is a good thing.

1) You are lucky enough to have a trust working towards a national standard.
2) As a carer you can learn more about what your trust is doing for carers and their loved ones.
3) You can use these standards to protect your rights.
4) You have a mental health trust that can link into partner trusts all working together for the good of unpaid carers.
5) Standards that can be measured and assessed by others.
6) A mental health trust brave enough to change its culture on unpaid carers.
7) A way to hold mental health trusts to account on how it engages and provides services for carers.
8) Hidden issues that can be unraveled by triangle of care.

Obviously the list can go on and continue to go on, but an NHS trust that can put some resources to the Triangle of care should be held in high regard among carers.

I am not saying that the system is perfect, it is NOT a quick fix solution, especially in the era of NHS cuts, cuts to staff, cuts to community services and a lack of understanding in mental health. We are also living in a complex society where so much is demanded from us, be it Brexit, having to struggle for education, fragmentation in communities and the lack of volunteering since everyone wants to be better off.

All I am saying is if you are an unpaid carer thinking how can your NHS trust support, engage or value you, then please see what they are doing with the Triangle of Care.

Although the triangle of care is going through some changes. You can find out more about the Triangle of Care below.

https://professionals.carers.org/working-mental-health-carers/triangle-care-mental-health/triangle-care-membership-scheme

 

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Gone too Soon

Sad man sitting head in hands on his bed in a bedroom at home

Just to note this particular blog can be triggering and not just for those suffering mental ill health needs, but also for families and carers.

As you can tell by the title of this particular blog post, this centres on the devastating experiences which mental ill health can cause to families and loved once.

There are some families that do not often get a chance to share their experiences when something tragic has happened to the person they are trying to support or care, although I know full well that this can also happen two close friends, relatives and perhaps even a neighbour.

As a care of myself I know in the back of my mind that there will a time when I will have to fight a mental health crisis for the person I support. Perhaps I will succeed, but I know out there carers up and down the country will have to deal with the devastating experiences when a loved one by finally succumbs to mental ill health.

melancholy and sad young  woman  at the window in the rain

I’m afraid I’m not going to pull any punches, when I mean succumb to mental ill health. I am talking about suicides, deaths due to addiction (alcohol or drug related), death Due to an accumulation of medication side effects causing massive strain on physical health. I am talking when the mental health sufferer cannot cope anymore with dementia, Parkinson’s or degenerative illnesses affecting the brain.

I am not going to use this blog post to lay blame at anyone’s door. However I just would like to raise the issue that’s such experiences need to be highlighted and discussed. We should never expect families and mental health sufferers to just cope and get on with it.

Coping with death

It is never easy to try and deal the situation when someone loses a loved one two mental illness. Unpaid Carers and families can often blame themselves as if they feel they have not done enough to save the loved one’s life. Some people think mental illness can only affect the one person who has been diagnosed with the condition.

In some ways this is possible, but not often the reality. We should try to avoid putting people in boxes. When death strikes a family due to mental ill health, i’m sure that grief, depression and anxiety will affect those that was close to the patient or service user. If you were a carer caring for someone long-term suffering from mental health, the grief stricken experiences will climb to unsustainable levels.

As unpaid carers it is important to respectively raise the awareness of coping with death, especially if you have been a long time carer. We all need to work together with the health services and our loved ones to avoid situations where patients might end up being failed by the system.

If anything off this post has affected you please call Samaritans on

116 123 (UK)
116 123 (ROI)

Thanks for reading.

Carers Rights Day 2018

smallerBefore you read this blog considered this, if you are an unpaid carer think of all the outcomes that you have experienced so far. Think of all the hardships that you and the person you care for has gone through.

Carers rights day

Every year organisations that deal with unpaid carers and support those using the health services come together and try to raise awareness of unpaid carers. CarersUK promote the awareness day and theme this year is “caring for the future”.

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Just so you know I will introduce the few terms in this blog. When I talk about an unpaid carer, I am not talking about a care worker. Care workers are paid to provide care to numerous clients. Unpaid carers provide care to those close to them.

Blood pressure measuring

Carer aiding her mother

Someone can become an unpaid carer for many different reasons. Unfortunately one of the reasons might not be out of choice. Considering the difficult role of unpaid carers, not many would want to rush into such a role. This is because there is a fear of the future, unpaid carers begin to wonder the following.

  • How their loved one will be supported.
  • How the carer themselves will be supported.
  • What happens if things go wrong.
  • Taking the unfortunate step to complain.
  • Wondering what would happen if they cannot care anymore.
  • Wondering what would happen if they loved one dies or moves on.
  • Wondering how they are going to cope if benefits are cut.

These are all serious issues and oh no laughing matter. If you have been an unpaid carer for as long as I have which is properly 20 years +. Think of the outcomes.

  • Has the lives of unpaid carers continued to improve over the past several decades?
  • Has services across the country decreased putting pressure on other services and unpaid carers?
  • Has funding increased for Carers Centres?
  • Has austerity improved the lives of families and carers across the country?
  • Has the number of carers increased across the country?

The statistics

Every year around 2 million people will take the unfortunate step to become a carer. Some carers will have to give up work to continue caring for a loved one, while other carers do not want to risk getting support from the benefit system. Like myself 3 million carers juggle work with a caring responsibility. Do not believe government’s being that all carers do not work. Plus caring is in a job itself, a very difficult job considering the outcomes I have mentioned earlier on.

Family

Group of people together holding hands

Do not get me wrong being a carer can be a rewarding job, but remember look at the outcomes. My aim is not to put you off in being a carer, but to remind you of your rights. I aim to remind you of your carer rights.

If you are an unpaid carer like myself. It is your right to speak up and tell it as it is. You as a carer should not feel ashamed if you have felt hard done by. Think of the outcomes if you feel that your loved ones life is ebbing away before your eyes. What is the risk? What is the cause? Who is to blame?

Never before has it been so important that carers are aware of their rights. It is so unfortunate that the care act 2014 can still seem so complex.

Carers rights.

Just as a note this is not an exhaustive list, but what is mentioned here are a set of important factors in the carers role. If you are an unpaid carer please consider what I have mentioned below.

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  • As a carer it is your right to get help with benefits and also get support to sustain your income.
  • As a carer it is your right to get support for therapy and counselling.
  • It is your right to get a carer’s assessment especially if you ask for a carer’s assessment.
  • As a carer you have the right to be fearful for the future, you have the right to ask for information.
  • If you are a mental health carer, the information you may ask for might give better outcomes for the person you are caring for.
  • As a carer you have the right to access advocacy, so in order to steer the ever-increasing maze of the health and social care system.
  • As a carer you have the right two access courses to aid in caring and learning about confidentiality in the Caring role.
  • As a carer you have to write to be supported with advanced directives, deputyships and power of attorney.

Final word

There are many reasons why carers across the country have a hard time. The thing is, carers can appreciate the awareness days, carers can appreciate strategies and policies set by carers organisations. Carers can appreciate the hard work the NHS does on behalf of their loved ones. Yet, if carers want real change, carers will have to lead from the front. Carers will have to implement a culture change. We must hear the carers voices. It is not just about organisation speaking on behalf of carers, carers must be given the power to speak for themselves and implement change.

Comforting friend. Woman consoling her sad friend.

Carer supporting loved one in Mental Health distress

Promoting your voice as a carer

insert_edited-1Hello, welcome to my latest blog. This particular blog is aimed at carers. This post hopes to be an inspirational message for anyone who is caring for a family friend or even a neighbour.

This post looks at promoting your voice as a carer. As a carer by our role, we give up so much and sometimes expect little, by definition health services and sometimes social services are aimed at the patient. Policies and laws can often assume that the family and carer are strong enough to cope by themselves.

Still, think about all the hard work energy and love you provide in caring for your loved one. No one else can tell you how to do your job, although they can provide some insight and maybe some support. So it is quite important that you use your voice as a carer to let others know how important you are in regards to services and policies.

Its all about Carer’s Voices

The risk is far too great if a carer does not speak out. Not only is the patient’s life or quality of life is at risk, but also the carer can suffer declining quality of life. When carers get desperate, they begin to risk so much and sacrifice so much such as time and energy. It is vital that you as a carer speak up, network and engage.

Silhouette of man showing his hand on sunset sky background, Successful business concept.

I am not only just asking you to speak up because your welfare depends on it. I am asking you to promote your voice because you should be valued as a carer. Just because you are a carer, does not mean that you should be ashamed to be a carer. Carers should be championed and valued for the things that they do for the family. If the community can learn from carers then we have a caring community.

Considering carers are unpaid, this is the least that carers can deserve. We should be encouraged to promote our voices, be it at events, forums, carer support groups, meetings and consultations. Carers should try to get out there and make a difference. Remember no one can tell you how to do your role, however they can advise.

Your caring experience is your own

Just as no one can fully tell you what to do, no one can fully understand what you are going through. No one can wear your shoes as you walk that difficult path in support in your loved ones journey through the health system. The emotional and physical turmoil a carer can go through cannot be fully understood, so it is vitally important that as a carer you speak out and get your voice promoted.

Sometimes as a carer we can be impatient and want change to happen straight away, but we must be practical considering the harsh changes is going through the NHS and social welfare system. Constant turnover of NHS staff can listen resources and support for carers. We need to realise that Rome was not built in a day. As carers we seek engagement, involvement and empowerment. Most carers will try their hardest not to harass and hassle those responsible for services, but unfortunately at the same time we do not want things to drag on and carers welfare is not Limitless.

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What services need to try and do regarding carers

I will make this as brief as possible, i’ll make this as gentle as possible. As carers, we want services to celebrate us. We do not want services to be scared of hearing carers voices. We want services to involve a so much that it seems like we are part of the team. Services should try to seek carers views. Services should try to engage with carers and invite them to service provision changes.

As carers we do not want services to keep referring carers on, we do not want services to keep passing the buck. We do not want services to be embarrassed of carers or afraid of carers.

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Due to these difficult times, as carers we must recognise that caring is just not enough. We must push our voices for more care support and work with those to get more better or creative services that help in the Caring role.

Learning from each other

As a carer please be interested in what the NHS is doing for you and the person you care for. Do not assume that the NHS is the expert in family and community care. We must all work together to enhance health and wellbeing in the family and in the community and eventually in Society.

Remember as a carer you deserve to be valued and championed, it is all about community and bringing out the best in ourselves. So think about using your voice as a carer to get your voice promoted.

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Holding MH Trusts to account via carer forums

2000px-NHS-Logo.svgWhat Carer forums need to take note of

Welcome back to my mental health blogsite. Most of the time I write about Unpaid Carers who support someone close requesting mental health needs or are suffering from mental illness. On this blog I am going to write about why Carer forums need to take note of what their local mental health trust is doing.

Quite a few mental health trusts do amazing work regarding patient care, but there should be a place where carers can get together with the trust and raise concerns. We all know the mental health service is struggling as of present and this can affect service users and their families.

Meeting Of Support Group

Just as a reminder, not all carer groups are the same. You can have a carer support group, where carers get to tell their story in a safe closed space. We can also have a forum where time is put into presentations, discussions and agendas. Lastly some carer groups have a mixed of presentations and carer stories where carer seek emotional support, some carer groups act as information hubs where peer supports or MH staff aide carers on how to get support.

Most of the issues below are usually covered in a Carer forum, where there is little or no time for carer stories and more time is spent on understanding why certain Trust problems are occuring.

  • Delays in providing the treatment.

Out of all the issues listed, this would be the most common that affects carers and those they seek to support. If the patient cannot get any treatment or support, then most if not all the support falls onto the family or carer who all too often will lack the skills to provide the treatment.

  1. Such treatment could be a bed/room to stay while recovering from a mental health crisis.
  2. Access to medication e.g. antipsychotics
  3. Access to psycho-therapy
  4. Information about their mental health and so on..

Delays usually occur if there are no beds, but even then the trust may not be fully at fault as GPs can often misdiagnose a mental health need. Lack of mental health staff can lead to delays as no one is available to provide a mental health assessment, which can often end up with the police stepping in wondering what to do. Within a Carer forum, carers should query with the mental health trust if there are any delays regarding treatment and query reports on how many patients have been seen at the trust.

  • Failure to provide appropriate medication.

Again, This is one of the most common issues that can affect the patient and carer. Medication is usually one of the core aspects of mental health treatment. Wrong medication can often cause the patient to deteriorate even further. What is even worse is if no medication is provided. Often the patient can refuse medication, it is their right, but due to mental health laws or MH Trust policies (we ll come to this later) there could be high levels of failures in providing medication.

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Without medication, service users can relaspe causing distress with family, friend and carer. Serious Incident levels begin to rise and Carer forums should query who is responsible for monitoring medication incidents.

  • Lack of referring patient or carer

This problem is not only common to mental health trusts, but also partner organisations. GP surgeries, Advice bureaus and even hospitals can fail here. Failure to refer patient or carer for support can leave both in isolation and desperation. Carer forums should not only query patient/carer leaflets, but also if there are a lack of carer information leaflets/booklets or why information has not been produced in a document.

  • Family/friend, GP or advocates ignored.

Going through past serious incidents, if you look back far enough you will find someone had been constantly ignored. Oddly enough even the gatekeepers to mental health services can be ignored. Carers can try to raise an issue with mental health professionals that their loved one is experiencing a crisis and needs to be assessed. Carers would either phone, email, write a letter or speak face to face with Mental Health Staff, but if nothing is done and a serious incident arises then it should be queried.

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Carer forums should have an interest to query if members of the forum have experienced this and if the trust produces reports regarding such issues. Maybe a Mental Health trust have a policy to tackle carer/patient requests. Carer forums should certainly discuss developments regarding the trusts patient database system and ask for database queries.

  • Insufficient or poor risk assessments

A poor risk assessment can certainly lead to incidents as mental health problems can go misdiagnosed. This leads to carers having to struggle supporting their ‘cared for’ in a crisis for longer amount of time. The problem is risk assessments are notoriously difficult to measure or even regulate. Members of the Carer forum should not only query how a risk assessment is done, but ask for reports on the number of assessments carried out and who at the trust are task with doing them.

  • Insufficient or lack of training

Lack of training can lead to all of the problems raised so far in this blog and even more. A mental health trust has a duty to continually train its staff, not only to help the patient but improve the quality of its staff. Mental Health staff should be patient and Carer aware. Carer forums should make a lot of noise if they continually hear stories of staff who do not understand what a carer is. I myself am fortunate to be included in helping to train staff at South London & Maudsley about families and carers, but there are some trusts that may not even provide training about carers or might not involve carers in their service.

Carer forums should ask for engagement from a trusts Staff training forum. Carer forums should have members who are active in training mental health staff and there should be involvement protocols to allow carers to be involved at the trust.

  • Confidentiality Issues

One of the biggest issues regarding carer and patient. I have been to many carer forums talking about the good and bad aspects of confidentiality. I have also been making a lot of noise about confidentiality, which I am sure has annoyed mental health professionals.

Why is this?

If carer is continually blocked on asking how their ‘loved one’ is coping or being involved at meetings, it might boil down to patient confidentiality, sometimes the patient will not want the carer involved, but it is a lot more tricky than that. Mental Health trusts have the duty to help the patient understand why the carer would want to be involved unless it is a safe guarding issue. Unfortunately confidentiality can be used as an excuse to avoid dialogue with the family or carer. Lack of confidentiality policies or booklets can cause confusion with staff and carer not knowing what to do.

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Carer forums should task themselves with who is responsible for confidentiality policies/booklets. Family and carers should also be involved in training staff about confidentiality.

  • Issues around discharge.

Due to bed management, patient discharge can happen too soon and sometimes might not happen at all. Some patients might be discharged because a bed is needed or a patient might be discharged because there has been a misdiagnoses of their MH needs. Discharge to a carer is risky if the carer is not prepared, informed or involved.

A carer forum should query a trust’s discharge pathway and seek engagement from the mental health trusts Quality improvement team.

  • Lack of appropriate care or continuity of care.

Another difficult issue to monitor or assess. Sometimes a mental health carer forum can pick up stories where carers are complaining that their ‘loved one’ is not getting any community care. It is vital a carer forum raises such stories to the trust otherwise families or carers may find themselves becoming the mental health team and being told to just “get on with it”.

  • Problems with protocols or policies.

Mental Health trusts can be pulled and pushed in all sorts of directions. Such problems can cause a trust not to update protocols and policies. If protocols and policies are not followed, then incidents can arise from them. Carer forums should ask for a list of policies related to carers (Expect the number to be large).

  • Patient was without care plan or the care plan in place was inadequate.

Difficult to measure due to confidentiality, but reports should be processed on the number of care plans done. Carer forums should most definitely be consulted with the CQC (care Quality Commission) who monitors and inspects health services. A patient without a care plan can often cause the carer to not know their role and this can lead to a lack of patient recovery.

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  • Poor communications between agencies and/or staff.

This is often a culture problem and unfortunately a carer forum may have to poke their nose into what the local council is doing. Healthwatch should be able to help the carer forum engage with other agencies, but if there continues to be poor communication between agencies then a number of health problems will not be picked up or delayed.

  • Poor communications with the patient or his or her family.

This might also boil down to confidentiality, but quite a lot of issues can be down to training, misinterpretation, lack of time or difficultly in building relationships. Issues of trust can also cause an issue here. Carer forums should keep an eye open if poor communication is happening at their local mental health trust.

  • Poor record-keeping.

The CQC can come down hard on mental health trusts on this issue. Mental Health trusts have been fined large sums for poor record keeping. If a patient has no record or is not past information required to their care, then the quality of care can go downhill.

  • Staff shortages or a lack of funding, available facility or available beds.

It has been unfortunate that Trusts have an appetite for Bank Staff or temporary MH staff. There are policies that have come into place to reduce reliance on Bank staff, but due to pay issues it has been known for staff to move into the field of becoming temporary since it pays more. Care forums should query if the trust is spending vast sums of money on bank staff, because without a doubt other MH services will suffer funding shortages and skilled professions.

  • Cover ups

Very difficult to tackle and this might be down to serious incidents being confidential. Mental Health trusts do not like being investigated or being fined, no one likes their reputation damaged. Unfortunately families and carers cannot sit around and have a MH trust culture to become silent. MP’s, councilors, Trust governors and other agencies can aide Carer forums if something is not right with the trust. To make matters worse there can even be collusion as everyone is trying to save money.

No one is usually in a rush to highlight cover ups, but if they are not tackled then every one suffers. There are usually signs when something is not right or investigations are taking too long.

  • Poor excuses

Ever heard of the term “Lessons learned?”. I will perhaps create a blog to poor excuses. If a trust fails to provide care to a large number of patients repeatedly then a carer forum should have space to work out why this keeps happening.

Carer forums and members of the trust should be engaged at trust events and space given to query what the trust actually have learnt from successes of failures.

The issues listed are very basic and some items have been missed due to lack of time. I can only hope whoever is reading has the strength, time and conviction to engage with their carer forum if one has been set up around their mental health trust.

Thanks for reading

Self Care Week

SCWwebbuttonlg2017Welcome back to another health awareness video. I have been gone quite a long while, but that doesn’t mean I have not been very busy. I usually am involved with many carer forums and groups in and around south/south east London. I try to raise awareness of unpaid carers who look after someone suffering from mental illness.

 

To see the video version, please click below

However there comes a time when we need to look after ourselves, be it if we are caring for someone or trying to care for ourselves. This video looks into Self Care week, which runs from November 13th to November 19th. The theme is Embracing Self Care for Life. Self care is about keeping fit and healthy, understanding when you can look after yourself and also when to askfor advice from a GP.

If you are unwell or suffer from a long term condition then it is very important you find out as much as you can in order to support yourself. Self care need not be so difficult if you know what you are dealing with.

family at sunset

Across the UK many suffer needlessly when dealing with weight problems, lack of exercise and stopping smoking. Getting information or attending events can be useful in combating unhealthy lifestyles. If you are caring for someone, you can easily fall into the habit of not paying much attention to your own health needs. It is an easy mistake to make especially when you have little time for yourself.

From the self care forum website, there are tips and advice not only for yourself, but for GP surgeries and pharmacists up and down the UK. It is a massive drive to get the population healthier and combat damaging habits to our health.

Young couple gets counseled by a doctor

You can find out more about Self Care week from the Self Care forum on http://www.selfcareforum.org/events/self-care-week/

Remember if you cannot find time to self care for yourself, think of how hard it would be for you to care for someone else.

Top 10 things that carers should like

fotolia_73087289_xsHello everyone to welcome another blog post for February. I usually do carer awareness videos and mental health videos.  You can check out my blog site, which has more information about mental health and carer awareness information.

Feel free to also check out my newspaper and my Twitter channel, I also have an audio site which has podcasts. However should updated that soon.

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