Standing Nursing & Allied Health Professionals Advisory Council 2011/12 Best Practice Guide Positive about integrated healthcare
Best Practice Guide 2011/12
Mar 30, 2016
A selection of 60 best practice examples from clinical services across the organisation.
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Standing Nursing & Allied Health Professionals Advisory Council
2011/12
Best Practice Guide
Positive about integrated healthcare
I am delighted to welcome you to you the clinical best practice directory of Nottinghamshire Healthcare for 2011-12.
The following information is a selection of 60 best practice examples from clinical services across the organisation. Each example has been carefully considered for inclusion under the four headings of Quality, Innovation, Productivity and Prevention (QIPP). These ideas were first raised at a celebration event held for Nurses and Allied Health Professionals in November 2010 and have been developed further since then.
As Executive Director of Nursing and Allied Health Professionals I am proud to lead this sharing best practice initiative. Many of our nurses and Allied Health Professionals deliver high quality and innovative practice which we should aim to share widely. Key deliverables and successes can be replicated across the organisation and clinicians need to know where to find this information and support.
These 60 examples are an indicator of exceptional clinical practice that bring the QIPP agenda to life. They are the tip of the iceberg of many and numerous examples of clinical excellence that exist across the Trust.
In summary this directory is a celebration of exemplar clinical practice from Nottinghamshire Healthcare and I commend it to you.
Janet Sheard Executive Director of Nursing and Allied Health Professionals
Introduction
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Welcome & How to Use this DirectoryA warm welcome to existing and all new Nottinghamshire Healthcare staff from Council Members of SNAAC (Standing Nursing and Allied Health Professionals Advisory Council).
SNAAC is the established Trustwide Nursing and Allied Health Professionals (AHP) forum of Nottinghamshire Healthcare meeting 9 times throughout 2011. Council members have supported the creation of this Directory of Best Practice and the planning of the Nursing and Allied Health Professionals’ celebration event in November 2010 from which this Best Practice Directory was formed.
Nottinghamshire Healthcare has a pedigree of strong Nursing and Allied Health Professionals (AHP) leadership. Nurses and AHP colleagues should be rightfully proud of the exceptional practice that happens across the Trust and this Directory is to celebrate just 60 of the many examples of this leadership and clinical practice.
It is hoped that by referring to key words in each section that best practice can be identified and shared across all of our services, existing and new; maximising the contact opportunities for dissemination and integration.
For our new colleagues, members of SNAAC have created the following summary of the main areas of Nottinghamshire Healthcare as it stood in March 2011.
We particularly now wish to welcome colleagues from Offender Healthcare and County Health Partnerships to our new integrated organisation.
Please make use of contact emails throughout the Directory and Council Member contacts below.
Suzanne Foulk, Chair of SNAAC
Adult Mental Health Services
Adult Mental Health (AMH) Services are delivered by two Directorates, AMH County and AMH City. Both Directorates provide a wide range of services across Nottinghamshire to adults experiencing short term or on-going and enduring mental health issues.
The service provision ranges from inpatient wards in Worksop, Mansfield and Nottingham to community residential units based in a number of locations across the County. Services include a wide range of community based multi disciplinary teams in Assessment & Treatment, Recovery, Early Intervention, Assertive Outreach, plus Occupational Therapy services, Social Inclusion, Wellbeing and Psychological Therapies.
Sue McGreevy [email protected]
Substance Misuse Services
Substance Misuse Services are a comprehensive range of services that offer varied support to people with substance misuse problems and their families. Services include the specialist community drug teams which operate in Nottingham and Mansfield.
Also in Substance Misuse Services are community alcohol services offering a therapeutic group programme, community detox and alcohol reduction as well as face to face support. Dual Diagnosis services are countywide and offer advice and support to mental health and substance misuse service users and offer face to face support for substance misuse and mental health needs. The Woodlands at Highbury Hospital is a new regional inpatient unit for drug and alcohol detoxification.
Sally Ann Summers [email protected]
Child and Adolescent Mental Health Services (CAMHS)
CAMHS work with children and adolescents from the age of 0 up to 18 years old in an outpatient setting and from 12 to 18 in a Nottingham based inpatient adolescent unit.
Services acknowledge the intricacy of childhood and adolescence combined with the complexity of having a mental health problem. The multidisciplinary teams offer holistic approaches to encompass physical, emotional and psychological development.
The adolescent unit caters for the most severe presentations of mental health difficulties and the MDT pride themselves in providing a bespoke treatment plan for each identified patient.
Claire Knight [email protected]
Standing Nursing & Allied Health Professionals Advisory Council
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Community Learning Disability Services
Learning Disability Services work to support people with a Learning Disability (LD) to remain safe and reach their potential. The service includes Assessment and Treatment Units (ATUs) where people can go when in crisis, Respite Services, Specialist Teams working within the Acute Hospitals, and also Community Teams that work closely with Social Services (Adult Social Care and Health).
The service has a real strength of working inter-professionally to support people with a learning disability establish their place in the community in which they live.
Josh Kay [email protected]
Mental Health Services for Older People (MHSOP)
MHSOP covers a range of inpatient and outpatient services for those with functional and organic mental health issues, generally for those over the age of 65 with some services leading on Dementia taking referrals for younger age groups.
Community Services include Acute Hospital Liaison Teams, Dementia Outreach into care homes, and day care services. Inpatient services are are based in Nottingham, Mansfield and Worksop. These teams offer initial assessment and treatment for people coming into contact with services for the first time. Challenging Behaviour units also provide more treatment options for those with severe and challenging issues.
Tom Rose [email protected]
Medium Secure Forensic Services
Two hospital based services in Leicester and in Wath upon Dearn (near Doncaster) provide a medium secure mental health service providing assessment, therapy, care and rehabilitation for adults who are detained under the Mental Health Act and may be subject to Ministry of Justice restrictions. Medium secure services receive referrals from the courts, high and low secure services.
The multi-disciplinary teams work with people with issues relating to metal health, substance misuse, offending behaviours and social functioning. This is provided through individual therapy and core group work. Services provide access to education, vocational rehabilitation, primary health care and social opportunities.
Katrina Watson [email protected]
Low Secure and Community Forensic Services
The Low Secure and Community Forensic Directorate provide services to individuals who pose a risk of harm to others in the context of their mental disorder. A close working partnership with Criminal Justice agencies, Adult Social Care and Health, other Trust Directorates and the voluntary sector is essential for the effective and safe delivery of these services.
The low secure inpatient services are male only and are provided on three wards at the Wells Road Centre in Nottingham. Community services consist of two multi disciplinary community teams. They are responsible for supporting and supervising patients living in the community, many of whom have been discharged from prisons or transferred from more secure hospitals.
Towards the end of 2011 The Wells Road Centre (WRC) will become a low secure hub. This will include the development and provision of two new low secure inpatient services: Learning Disability and a Woman’s Service.
Justin Boyle [email protected]
Rampton Hospital
Rampton Hospital is a high secure psychiatric hospital because of the particular patients under its care. These people suffer from mental disorders that need treatment in conditions of special security because of their dangerous, violent or criminal tendencies. Prior to admission, every patient must fulfil two criteria. They must be detainable under the Mental Health Act 1983, under one of the classifications of mental disorder as defined under Section 1 of that Act. Secondly they must be considered to require a high security hospital placement and be deemed as being of a grave and immediate risk to others.
The Hospital is situated on a 77 hectare site in a rural part of North Nottinghamshire, six miles from Retford. The patient population at Rampton Hospital is just under 350. Approximately 50 of this total are women, around 50 patients are diagnosed as suffering from a Learning Disability and the remainder have a major Mental Illness or a Personality Disorder. The diagnosis determines where in the Hospital a patient is accommodated.
Rampton is the centre for three national high secure services: Women’s, Learning Disability and Deaf Services. In addition the Hospital has Directorates providing personality disorder services, severe and dangerous personality disorder services and mental health services with support from security services, therapies, education services and physical healthcare teams.
Louise Bussell [email protected]
Quality
The essential element of the Quality agenda for the
NHS is care. The quality of care provided by the NHS
is measured through the experience of patients with
further information about quality being used to
drive up standards.
Patients, service users and carers are encouraged
to be partners in their own care and can expect
Nottinghamshire Healthcare to make improvements
in the things they have said they want from their
health service.
The following sixteen examples from the
celebration day highlight the diversity and richness
of quality interventions that are undertaken by
teams in Nottinghamshire Healthcare.
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Implementing the Knowledge & Understanding Framework (KUF); Raising Awareness in Personality Disorder
Family and Carer Information Packs
Online Running Records of Client Interaction
Partnership Working between Nottinghamshire Healthcare and local Universities to Promote Mental Health issues among the student population
Creating a Safe Environment for Clients to Detoxify from Alcohol Using Medication
Alcohol Consumption and Impact on Mental Health Issues. A Holistic Approach to Care
Structured Day, Activity Supported by Social Inclusion Nurses
Alexander House Activity Timetable for Patients with Learning Disabilities
Maintaining Activities to Engage a Patient
Primary Health Care Staff Integration with Ward Based Clinical Staff
Hosting an Age Equality Conference
The Early Intervention in Psychosis Team support young people aged 16-30. The team organise weekly drop win sessions as social space for those who use the service
Service User Led Group
Development of Family Therapy Clinic supported by Reflective Practice
Providing Evidence Based Assessments & Interventions for Young People who Self Harm
Short Breaks Service for People with Complex Needs
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Title of Best Practice ExampleFamily and Carer Information Packs.
Summary of the Best Practice ExampleClinical work with clients experiencing first episode psychosis. The information packs are specifically designed to inform and educate; providing hope for families who may be struggling to comprehend the illness and provide information on treatment and outcomes.
Outcome/outputs• Relevant information gathered on “What is
psychosis” and what support will be provided to clients and their families/carers.
• What treatment options are available including psychotherapy/social inclusion/education and training and pharmacological.
• Sign posting for other services such as carers' breaks, family and friends' meetings appropriate 3rd sector organisations .
Key Words Family Carer Packs
Contact name and e-mail for more informationStephen Laird (The Early Intervention in Psychosis Team (EIP) City and County South)
Title of Best Practice Example
Implementing the Knowledge & Understanding Framework (KUF); Raising Awareness in Personality Disorder.
Summary of the Best Practice Example
A full roll out of KUF training across the Peaks Unit including all staff regardless of professional background and experience.
Outcome/outputs
• Raise awareness in PD.
• Challenge myths/stigma around PD.
• Challenge attitudes.
• Ensure service users are at the heart of our provision.
• Improve service user experience.
• Develop self awareness and reflective practice in staff.
Key WordsKUF PD Awareness Training
Contact name and e-mail for more informationAndrea Milligan (Peaks Unit, Rampton Hospital)
Title of Best Practice ExampleOnline Running Records of Client Interaction.
Summary of the Best Practice ExamplePatient contact is securely recorded electronically so that the multi-disciplinary team composed of nurses (CPNs), Doctors, Social Workers, Psychologists and Support workers can remain fully up to date.
Outcome/outputs• Each community forensic client has an online directory on the shared drive (secure to Forensic Team
members). This directory holds information about the client e.g. CPA notes, letters sent out etc.
• This information is held in the clients' paper file. Each time a team member visits (or has a significant phone contract) with the client then details of that interaction are recorded in a dated file. This enables any team member to identify if there are any issues that they need to be aware of before they next interact with the client.
Key Words Information, Risk, Interaction
Contact name and e-mail for more informationSharon Esprit (Community Forensic Team County and City) [email protected]
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Title of Best Practice ExamplePartnership Working between Nottinghamshire Healthcare and local Universities to Promote Mental Health Issues among the student population.
Summary of the Best Practice ExampleEffective partnerships have been developed between the City and County South Early Intervention in Psychosis Team (EIP); working with both Nottingham Trent and Nottingham University in tackling stigma, discrimination, and lack of understanding of mental health issues, particularly information and understanding about psychosis.
Outcome/outputs• Initial meetings with university mental health staff to identify possible initiatives
(due to high number of students being referred to EIP).
• Development of health promotion material.
• EIP’s attendance at fresher fayres and health promotion road shows in halls of residence.
• Partnership funding.
• Increased awareness of psychosis for students and reduced duration of untreated psychosis (DUP).
• Partnership developed and strengthened over a 3 year period.
• Joint working now taking place between university mental health staff and EIP care coordinators.
Key Words Partnership Health Promotion Universities
Contact name and e-mail for more informationErica Bore (The Early Intervention in Psychosis Team (EIP) City and County South) [email protected]
Title of Best Practice ExampleCreating a Safe Environment for Clients to Detoxify from Alcohol Using Medication.
Summary of the Best Practice ExampleDetoxification of clients from alcohol, in the safe environment of the unit (Oxford Corner). This follows risk assessment and medication dispensed by members of the multi-disciplinary team. Physical observations are closely monitored and discussions take place regarding withdrawal symptoms and side effects of medication. Medication can be given for clients to take at home with carer support.
Outcome/outputs• Key worker and Doctors assesses for suitability for Detoxification.
• Physical health, level of drinking in home environment and history of severe alcohol withdrawal is assessed.
• Client is assessed on arrival for detoxification. Physical observations are recorded and medication dispensed.
• Discussions are undertaken to assess symptoms and side effects.
• Care plans for post detoxification are collaboratively made.
• Process is thoroughly risk assessed.
Key Words Alcohol Detoxification
Name of the Unit/Team Ward that has hosted or led the Best PracticeOxford Corner
Contact name and e-mail for more informationJasmine Feakes (Oxford Corner; Substance Misuse Services) [email protected]
Standing Nursing & Allied Health Professionals Advisory Council
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Title of Best Practice ExampleAlexander House Activity Timetable for Patients with Learning Disabilities.
Summary of the Best Practice ExampleAlexander House is a locked rehabilitation community unit that offers an activity timetable with structure and a goal to maximise social inclusion. Activities include: psychological therapies, education, college courses, exercise, and well men’s groups. The structure and activities establishes meaningful activity thus reducing difficulties associated with boredom. Activities are aimed at preparing clients for community inclusion.
Outcome/outputs• Client choice and input into their activity timetable. • Programme is continuously reviewed.
• Both group and individual activity is available. • Timetable is flexible to suit client need.
Key Words Activity Timetable
Contact name and e-mail for more informationBen Pressley (Alexander House; Learning Disabilities Services) [email protected]
Title of Best Practice ExampleAlcohol Consumption and Impact on Mental Health Issues. A Holistic Approach to Care.
Summary of the Best Practice ExampleThe team considers the many aspects of a client’s life where there is an impact on their alcohol consumption. The team work with these individuals directly to improve these areas or liaise with other services who are specialists in a particular area. Particular emphasis is put upon issues directly impacting on mental health.
Outcome/outputs• Anxiety management on an individual basis
e.g. groups using Beck anxiety inventory to identify particular areas to focus on.
• Women’s group sessions focusing on areas to improve mental health such as assertiveness, self esteem, confidence building, stress management.
• Regular visits organised from other agencies specialising in housing problems, work and training. Vocational activities which clients are encouraged to attend.
Key WordsAlcohol, holistic, mental wellbeing
Contact name and e-mail for more informationGail White (Alcohol Team; Substance Misuse Services) [email protected]
Title of Best Practice ExampleStructured Day, Activity Supported by Social Inclusion Nurses.
Summary of the Best Practice ExampleEstablishing a service to the patient group that supports a meaningful day and social inclusion. Impact is a relief from boredom, reduction of incidents and improvement in well being.
Outcome/outputs• Appointment of three members of staff to
support the agenda.
• Formulation of individual and ward programmes.
• Provision of social and community based activities.
• Healthy living agenda profiled.
• Liaison with local medium secure unit to arrange exchange programme to share practice and develop new ideas.
Key Words Social Inclusion
Name of the Unit/Team Ward that has hosted or led the Best PracticeWells Road Centre
Contact name and e-mail for more informationJustin Boyle (Thurland Ward and Trent Ward; Low Secure and Community Forensic Services)
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Title of Best Practice ExamplePrimary Health Care Staff Integration with Ward Based Clinical Staff.
Summary of the Best Practice ExamplePrimary Health Care Staff at Wathwood Hospital also work within ward areas. Many staff believe that effective relationships are created and maintained throughout the patients stay.
Outcome/outputs• All patients have a health review on
admission to Wathwood Hospital.
• Maintaining compliance and good therapeutic relationships.
• Seen by visiting GP within 72 hours.
• Referrals made to support services.
• Other facilities/services available on request/referral.
• Continuous monitoring, health reviews and diagnostics of physical health problems.
Key WordsPrimary Health Care Integration
Contact name and e-mail for more informationJayne Marriot (Primary Health Team; Wathwood Hospital)
Title of Best Practice ExampleMaintaining Activities to Engage a Patient Group who are Frequently Considered as Those who Will Not Engage.
Summary of the Best Practice ExampleWithin the dangerous and severe personality disorder service at the Peaks Unit, NHS staff are able to create therapeutic relationships with a patient group who historically are the most difficult to engage.
Outcome/outputs• Human approach.
• Care skills training.
• Non-judgemental approach.
• Recovery.
• Treat people as individuals.
• Enjoy human contact.
• Motivating people.
Key WordsEngagement, Non Judgemental, DSPD
Contact name and e-mail for more informationDane Brennan (Peaks Unit, Rampton Hospital)
Title of Best Practice ExampleHosting an Age Equality Conference.
Summary of the Best Practice ExamplePresenting a conference on age and mental health, open to external agencies and groups. Widening people’s general awareness of how mental health issues can impact on people of any age including children.
Outcome/outputs• Best practice collecting from Directorate’s involvement of the third sector.
• Bringing together groups of clinical specialists.
• Use of volunteers and community groups.
Key Words Age equality inclusion
Contact name and e-mail for more informationAndrea Ward (Representing the Trusts Age Equality Group) [email protected]
Standing Nursing & Allied Health Professionals Advisory Council
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Title of Best Practice ExampleService User Led Group.
Summary of the Best Practice ExampleService Users become involved in their care by supporting direct participation in the running of groups. Asking service users their opinions on what they enjoy or don’t enjoy and what topics they would like to cover. Getting service users to evaluate groups, which helps increase skills, confidence and sense of accomplishment.
Outcome/outputs• Formalised user involvement.
• Encouraging participation to communicate ideas.
• Talking to service users to discuss how groups can give support.
• Practice running of group with service users.
• Give support during the group.
• Evaluate group with service users at end of groups.
• Confidence, skills, achievement.
Key Words Group, Occupational Therapy, Service User
Contact name and e-mail for more informationAnna Heames (Occupational Therapy Team, City Adult Mental Health Services)
Title of Best Practice ExampleThe Early Intervention in Psychosis Team supports young people aged 16-30. The team organises weekly drop in sessions as social space for those who use the service.
Summary of the Best Practice ExampleThe clinical team has had discussion groups with service users, around equality and diversity, keeping safe and black history month. We have had events on these topics where the service users where able to demonstrate how they have developed using these discussion groups. Evaluation has been done before and after on the knowledge of the topic.
Outcome/outputs• Equality and diversity: The team hosted group sessions over a three week period.
• Evaluation on knowledge before discussion.
• Had speakers on the topic, hand outs and information.
• Evaluation of what had been learned.
Key Words Diversity
Name of the Unit/Team Ward that has hosted or led the Best PracticeEarly Intervention in Psychosis
Contact name and e-mail for more informationKalwant Kandola (Early Intervention in Psychosis; Adult Mental Health Services)
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Title of Best Practice ExampleProviding Evidence Based Assessments and Interventions for Young People who Self Harm.
Summary of the Best Practice ExampleDeveloping a care pathway – outlining the process of evidence based practice for young people who self harm. Clearly identifying what young people can expect at each stage and how outcomes are measured.
Outcome/outputs• Development of CAMHS self harm care pathway to ensure young people receive a timely assessment
and intervention by specialist team.
• Includes evidence based assessment, timely follow-up and individually tailored intervention including individual work, family work and group work.
• We receive feedback from young people and carers/parents after every appointment and use this information to evaluate and where indicated change the service delivery.
• We work collaboratively with young people/families developing joint care plans via the CPA process.
• The group work is formally evaluated through the Institute of Mental Health – and demonstrates positive changes and beneficial impact on the young people.
• The team liaise with the network around the young person and support others working with young people who self harm.
Key Words Self Harm & Young People
Contact name and e-mail for more informationMarie Armstrong (Self Harm Team; Child and Adolescent Mental Health Services)
Title of Best Practice ExampleDevelopment of Family Therapy Clinic supported by Reflective Practice.
Summary of the Best Practice ExampleLive supervision, a reflecting team and case discussions are held twice weekly. A range of different times enables professional development to be organised at appropriate times. Families benefit from collective expertise and value shared professional experience.
Outcome/outputs• Trained systemic family therapists developed clinics as a way of supporting colleagues/family in more
complex cases.
• Evidence base indicates family therapy as intervention.
• Team of 3-4 clinicians observe therapist families.
• Letter devised explaining process to families.
• Clinicians can refer to the clinic – expectation that they will continue to work with the family .
• Creative ways of thinking.
• Training opportunities for professionals.
Key Words CAMHS, Family Therapy
Contact name and e-mail for more informationCaroline Prance (Family Therapy Team; Child and Adolescent Mental Health Services)
Standing Nursing & Allied Health Professionals Advisory Council
Title of Best Practice ExampleShort Breaks Service for People with Complex Needs.
Summary of the Best Practice ExampleProvision of respite care for people with learning difficulties, to enable carers to have support from nursing care for their son/daughter, throughout the year or times of need.
Outcome/outputs• 24 hour nursing care.
• Homely environment for service users to stay in.
• Support during times of crisis at home/hospital.
• Regularly review service users health and needs.
• Maintain regular contact with MDT; carers, service users.
• All service users have up to date health file/HAP follow EBP.
• Carers pick/choose own allocations.
• Pre and post stay contact and clinical summaries.
Key Words Respite, Learning Disabilities
Name of the Unit/Team Ward that has hosted or led the Best PracticeNewlands
Contact name and e-mail for more informationJan Blackwell, Kirsty Storer & Katherine Allport (Newlands; Learning Disability Services)
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Innovation is about doing things differently
or doing different things to achieve gains in
performance. Nottinghamshire Healthcare
acknowledges that the innovators are the clinicians,
managers and support staff that deliver healthcare.
A critical component of this agenda is service
innovation. It involves designing the process our
service users and patients go through, the way we
work and the way we redesign and develop our
health services.
Nottinghamshire Healthcare Nurses and Allied
Health Professionals consistently rise to the
challenge of innovation and this is seen clearly in
the following nineteen examples of good practice.
Innovation
Good Practice Guide
Root Cause Analysis
Nursing Assistant Development Booklet
Named Nurses Development Programme and Training
Citizens Advice Bureau Support for Carers
Conversion of Nursing Office to Clinical Session Space
Service User Involvement for Arnold Lodge Events
Intensive Interaction and Sensory Integration
Creation of a Dedicated Team of Motivational Workers
Quality Uninterrupted Intervention and Engagement Time (QUIET)
Alcohol Services Service User Panel
Cost Effective Hydrotherapy
Ecological Approaches for Clinical Services
Efficient Delivery Model to Provide Essential Training
Creating and Leading the Nottingham City Asperger’s Service
Taking Services to Hard to Reach Clients
Accessible Exercise Programmes
Service User Involvement in Interview Process of Occupational Therapists
Involving Service Users in Evaluation of Arts Therapies
Peer Led Recovery Group
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Title of Best Practice Example
Named Nurses Development Programme.
Summary of the Best Practice ExampleCreation of a series of three work books that support the professional development of registered nurses.
Book 1: Role of the Named Nurse.
Book 2: Therapeutic Relationships and Boundary Management.
Book 3: Supporting Patients' Journey through the Nursing Process.
Outcome/outputs
Key Words Named Nurse Training
Contact name and e-mail for more informationAlison Tennant (The Peaks Unit, Rampton Hospital) [email protected]
Title of Best Practice ExampleReducing Workplace Violence in the Mental Health and National Learning Disability Directorate.
Summary of the Best Practice ExampleThe development of a team to review and analyse workplace violence using a model of root cause analysis. This process creates and develops action plans to minimise future violent occurrences through a lessons learning communication system.
Outcome/outputs• Establishing the group, creating terms of
reference and group membership.
• Data/information gathering and scoping.
• Agreeing outcomes (risk assessment changes in practice training).
• Agreed action an outcomes.
• Communication improvement across the service.
Key WordsRoot Cause Analysis, Work Place Violence
Contact name and e-mail for more informationDavid Jones (Violence Action Group: Rampton Hospital) [email protected]
Title of Best Practice ExampleNursing Assistant Development Resource.
Summary of the Best Practice ExampleCreating a Nursing Assistant / Healthcare Assistant booklet covering a range of skills to support professional development. This resource encourages positive nursing skills with patients and professional practice alongside registered staff.
Outcome/outputs• Creation of a usable document.
• Review of the packages already developed.
• Identify key skills already used.
• Inclusion of the recovery model being launched.
• Pilot and review of the project.
Key Words
Nursing Assistant Development Booklet
Contact name and e-mail for more informationJohn Smith & Allison Tennant (Peaks Unit: Rampton Hospital) [email protected] or [email protected]
• Proposal – innovation award.
• Audit (RIO, report writing) – further training and pack developed.
• Theory into practice (practice based learning).
• Evaluation (robust research strategy running alongside programme).
• Questionnaire survey monthly – pre and post – competency based.
• Focus group – pulling out named nurse experiences of working with men who have complex problems.
• Clear outcomes for each work book.
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Title of Best Practice ExampleService User Involvement for Arnold Lodge Events.
Summary of the Best Practice ExampleA service user involvement committee has been set up to plan, implement and coordinate a unit-wide programme of events.
Outcome/outputs• Patients are involved in selecting and
planning events.
• Promotion of teamwork throughout the unit/ staff from all areas and departments are supported to be involved.
• The committee has an overseeing role in all events including charity work which means events can be spread out all over the year.
• Raises profile of Arnold lodge.
Key WordsService User Involvement, Events, Team Work
Contact name and e-mail for more informationJames Routen (Arnold Lodge)
Title of Best Practice ExampleCitizens Advice Bureau Support for Carers.
Summary of the Best Practice ExampleThe Citizens Advice Bureau (CAB) will offer a monthly service on site (within Adult Mental Heath Setting), starting in January 2010. Carers will be able to have a named adviser who can help them with debt and financial difficulties.
Outcome/outputs• Positive negotiations to discuss working together.
• Agreement in principle – insurance, contracts, CAB etc needs to be investigated further.
• Management support and acknowledgment.
• Negotiations of; how many advisors, length of sessions, frequently, location.
• A potential pilot for the trust.
• To be made accessible to all teams if possible.
• Bringing other services together under one roof for clients/carers.
Key Words Citizens Advice Bureau Sessions, Debt & Benefits Advice, On Site Provision
Contact name and e-mail for more informationAmanda Feuz (Carer Support Service: City Adult Mental Health Services) [email protected]
Title of Best Practice ExampleConversion of Nursing Office to Clinical Session Space.
Summary of the Best Practice ExampleDaybrook Ward had limited available space to meet with clients and carers in a relaxed, pleasant and uninterrupted setting. The space has been created using existing staff offices.
Outcome/outputs• Ward staff have commissioned a conversion
of a nursing office into a chat/chill out room.
• Creation of a pleasant setting, appropriate decoration, furniture and lighting.
• Appropriate use of wall art.
• An environment conductive for released discussion that feels ‘clinical’.
• Improved client and carer interactions.
Key WordsImproved Client and Carer Interactions
Contact name and e-mail for more informationGary Wheatcroft (Daybrook Ward: Mental Health Services for Older People)
Standing Nursing & Allied Health Professionals Advisory Council
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Title of Best Practice ExampleIntensive Interaction and Sensory Integration for Person with Complex Needs.
Summary of the Best Practice ExampleWork developed in partnership with occupational therapy to combine aspects sensory integration and intensive interaction for people with profound and multiple learning disabilities. Work is located in a day service. Support to staff to learn about approaches and how they were useful for the individual.
Outcome/outputs• Took advantage of good timing to work with O.T. as she was already working with individual.
• Learned from each other, though discussion and observation.
• Worked along side day service staff regularly so that they learned alongside us.
• Regular contact with staff including training and attending staff meetings.
• Attending person centred review – made sure that approaches were included in record of review.
• Used film as well as recording so that staff could see approaches being made.
Key Words Intensive Interaction and Sensory Integration
Name of the Unit/Team Ward that has hosted or led the Best PracticeSLT + OT (Adult learning disability service)
Contact name and e-mail for more informationSue Pearson (Speech and Language Therapy & Occupational Therapy: Learning Disability Services)
Title of Best Practice ExampleCreation of a Dedicated Team of Motivational Workers.
Summary of the Best Practice ExampleResources were successfully identified to support the development of a dedicated service to work with women patients in high security who lacked motivation to engage in activities and therapy. This small team has been successful and is an example of something that is not restricted to one service.
Outcome/outputs • Formal bid identifying the service needs and aims for the project.
• Detailed job description.
• Robust recruitment process.
• Team development and integration into wider service.
• Launch day.
• Additional innovative service to the patient population.
• Timetable compiled with patients.
• Audit and evaluation including patients surveys.
• Team review and development process to monthly reports of progress.
Key Words Motivational; Women’s, Rampton
Contact name and e-mail for more informationLouise Bussell (Women’s Service: Rampton Hospital) [email protected]
Good Practice Guide
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Title of Best Practice ExampleAlcohol Services Service User Panel.
Summary of the Best Practice ExampleThe Alcohol Service (Substance Misuse Services) at Oxford Corner has a well established Alcohol Service User Panel (ASUP) which has been meeting once a month for the past two years. This panel consists of ex service users and current service users, volunteers and Involvement team members. It links well with other groups. Panel members sit on other user groups such as the alcohol service user forum (ASUF) which is City wide.
Outcome/outputs.
Key Words Service User, Panel, Alcohol
Contact name and e-mail for more informationJackie Quenby (Oxford Corner Alcohol Service: Substance Misuse Services) [email protected]
Title of Best Practice ExampleQuality Uninterrupted Intervention and Engagement Time (QUIET).
Summary of the Best Practice ExampleProvision of therapeutic activities on an acute Mental Health Admission Unit. The ward has protected time periods (1400 – 1600 hours weekdays). External facilitators organised by activity coordinator support a range of groups. These include: mind social group, psychology (thinking skills), long term health conditions course (staying well) and a recovery group.
Outcome/outputs • Staff engaged in identifying areas of interest to be link nurse, this role extended to provision of groups
where possible.
• Activity coordinator employed for 2-7 weeks.
• Role of activity co-ordinator to arrange external facilitators for groups.
• Many facilitators achieve targets by facilitating group i.e. rainbow learning.
• Devoting 2 hours a day for QUIET time.
• Each group has aims and objectives and is continually evaluated.
• Motivated and dedicated staff; involving the wider MOT team (doctor, community teams).
• People learning and developing new aspects to their clinical role.
Key Words Protected Time, Activities, Acute Ward
Name of the Unit/Team Ward that has hosted or led the Best Practice Ward B2
Contact name and e-mail for more informationSimon Barnitt & Beth Grimditch (Ward B2: County Adult Mental Services) [email protected]
• Initial questionnaire to elicit service user interest.
• Meeting with potential members and chairs of other panels.
• Setting out membership and recruiting to panel.
• Meeting regularly (even if low numbers to keep consistency).
• Feedback from other forums to panel and from panel to other forums.
• Recognising change can take place based on service user feedback.
• Implement changes where appropriate.
• Setting out terms of reference.
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Title of Best Practice ExampleInnovative Approach to Re-establishing a Valuable Hydrotherapy Rehabilitation Service.
Summary of the Best Practice ExampleIn 2007, a hydrotherapy pool used by Nottinghamshire Healthcare was closed. As a team we explored many options and made links with a school who offered us use on one afternoon a week.
Outcome/outputs • Evaluation of the strengths and weaknesses of
the previous service.
• Establishing what resources were available.
• Negotiating how this would happen and the logistics of it.
• Matching the most needy service users with the resource.
• Providing a valuable service in a new format that was more cost effective and sustainable than previously.
Key WordsHydrotherapy, Cost Effective, Change
Contact name and e-mail for more informationJosh Kay (Physiotherapy Team: Learning Disability Services) [email protected]
Title of Best Practice ExampleEcological Approaches for Clinical Services.
Summary of the Best Practice ExampleCost improvements have been achieved in the clinical services using recycling, paper saving approaches. New approaches to energy consumption now exist within team.
Outcome/outputs • Recycle UIC cartridges.
• Low level lighting and use of energy efficient lighting.
• Shredded paper used for animal bedding.
• Developing a green environment – planting nurtured.
• Hot desks and use of shared Personal Computers.
• Email letters rather than printing draft copies.
Key WordsEcological Saving and Cost Improvement
Contact name and e-mail for more informationMandy Hudspith (Oxford Corner Alcohol Service: Substance Misuse Services)
Title of Best Practice ExampleEfficient Delivery Model to Provide Essential Training.
Summary of the Best Practice ExampleCreating a continuity of training for Local Services that maintains statuary training requirements and supports best clinical practice. Training is being evaluated at four different sites.
Outcome/outputs• Increased percentage uptake of essential training.• Innovative product based on experience elsewhere in the organisation.• Minimising workforce disruption, enabling release of time to attend. • Best use of resources (staff & trainers).• Straightforward approach for releasing inpatient staff.• Assists General Managers to achieve 80% training target.
Key Words Essential Training
Contact name and e-mail for more informationKevin Warren (Learning and Development Department: Duncan Macmillan House)
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Title of Best Practice ExampleCreating and Leading the Nottingham City Asperger’s Service.
Summary of the Best Practice ExampleA unique service development, providing diagnosis, treatment and support to adults with Asperger’s Syndrome. The team have clear pathways to enable users to access a diagnosis but also support to models where individuals no longer suffer social exclusion and isolation.
Outcome/outputs
Key Words Asperger’s, Diagnosis, Autism
Contact name and e-mail for more informationJacqui Dziewanowska (Nottingham City Asperger’s Service: Learning Disability Services)
Title of Best Practice ExampleTaking Services to Hard to Reach Clients.
Summary of the Best Practice ExampleSex workers were reluctant to access mainstream services, so the team took the service to them. A clinical nurse specialist in substance misuse and a GP with a special interest offers a weekly drug clinic at POW (Prostitute Outreach Workers).
Outcome/outputs• Obtaining a venue at POW, advertising the new service within the sex working community.
• Clinical Nurse Specialist (CNS) has visits the project regularly so when the clinic commenced there was familiarity to the clients. These clients are often reluctant to trust professionals and view them with suspicion.
• GP and CNS offered very informal and welcoming clinic, with minimal paperwork as the clients would not tolerate hour-long appointments.
• Within six months a second clinic was needed, and there are currently approximately 50 clients in regular drug treatment.
• Some have completed detoxification and/or rehabilitation.
Key Words Sex Working, Drugs, Treatment
Contact name and e-mail for more informationJackie Slater (Primary Care Liaison Team: Substance Misuse Services) [email protected]
• Business plan submitted Nottingham City NHS (PCT).
• Finances agreed and recruitment of team progressed.
• Establishing links with key services e.g. AMH, CAMHS, Forensic and Social Care.
• Development of an extensive care pathway.
• Use of nationally researched diagnosis tools.
• User involvement through Community of Interest and groups.
• Establishment of clinics.
• Full service evaluation with Nottingham University.
• Annual report to the Board and Primary Care Trust.
• Established training packages.
• Provision of extensive clinical supervision to staff.
• Women’s groups.
• Social skills groups.
• Post diagnostic support.
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Title of Best Practice ExampleService User Involvement in Interview Process of Occupational Therapists.
Summary of the Best Practice ExampleEnabling Service Users to have the opportunity to be part of the interview panel, or feed in questions to staff on the panel through the group.
Outcome/outputs• As part of a Social Skills group facilitated by O.Ts, Service Users have learnt skills, and had opportunities
to be part of an interview panel for Bands 5 and 6 O.Ts.
• In the Social Skills group the Service Users worked together to come up with questions, all of them having the opportunity to have a say and be heard of what they want from a staff member.
• Due to the group Service User discuss how they have built up confidence and skills to interact with others.
• As a consequence of being on a panel, the Service User has felt possibly able to think about taking part on The Trust Interview Training.
• Service User was encouraged to share experience with others in the group.
• Having Service Users on the panel gives them a voice. It teaches them skills and enables opportunities that in most other cases in LD they would not have. Start a process of opportunities/new experiences.
• Have links also with Involvement Team now for Service Users who have participated on the training. In the future I would like to extend to carers as well.
Key Words Service User Involvement
Contact name and e-mail for more informationSam Jaques Newton (Community Occupational Therapy Service: Learning Disability Services)
Title of Best Practice ExampleAccessible Exercise Programmes Created Around Client Need.
Summary of the Best Practice ExampleCreating exercise programmes that are accessible for a specific client group. Design makes ongoing support from the clients other health professionals, their family or carers easier to maintain the exercise programme.
Outcome/outputs • Programmes individually produced that include photographs, signs and symbols making it accessible for
service user with learning disabilities.
• Working together with support workers, carers, family members, other health professionals to implement such programmes into the daily routine of the client.
• Teaching of programmes so that other members of the multi disciplinary including staff at the day centres are able to carry out programme.
• All participants and supporters of that client have an understanding of the purpose of initiating and implementing the service.
Key Words Learning Disabilities, Physiotherapy, Client specific programmes
Contact name and e-mail for more informationTracy Mercer (Bassetlaw Community Learning Disability Team: Specialist Services Directorate)
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Title of Best Practice ExampleInvolving Service Users in Evaluation of Arts Therapies.
Summary of the Best Practice ExampleThe Arts Therapy Department has been running clinical pilots over a 2 year period offering music and art therapy to service users who have not had the opportunity to access these interventions previously. Service users have been fully involved with evaluating the effectiveness of the project.
Outcome/outputsAims of project
• To measure and gather evidence as to the effectiveness of Music and Art Therapy with adults with learning disabilities (in particular those who have been affected by abuse, trauma or neglect).
• To make future recommendations for the availability of a specialist Arts Therapy Service.
• To improve access to Physiological Therapies to clients in the LD service.
Preparation
• Questionnaires were produced for staff in the new teams we linked in with. This helped us to gauge understanding of what we offered meaning we could provide effective “awareness workshops”, meaning we received additional referrals.
Evaluation
• Service was provided with accessible end of therapy questionnaires so they could feedback on their experience of the service.
• Carers and referrers also had opportunities to fill in questionnaires about the service.
• Service users were fully involved in the therapy process with suggesting aims and deciding how therapy would proceed (The Arts Therapists are always client centred, and adaptable working with the individuals concerned).
Findings (Art Therapy evaluation)
• 80% of respondents to the client questionnaire said they believed that it had helped them a lot.
• 20% believed it had helped them a bit.
• 70% of referrers and carers believed the service had helped clients a lot.
• MDT gained knowledge and understanding of benefit of Arts Therapists to their clients.
• Although there is no funding to continue the projects in the current form. The Music Therapy department is currently looking into restructuring to provide a wider service and maintain the new links forged with teams across the County.
Key Words Arts Therapies, Trauma, Abuse, Music
Contact name and e-mail for more informationNathan Bettany (Arts Therapy Service: Learning Disability Services)
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Title of Best Practice ExamplePeer Led Recovery Group.
Summary of the Best Practice ExampleThis recovery group in Adult Mental Health Services is peer rather than staff led. Topics discussed are chosen by peers and as a result of meeting together there is opportunity for peer support relationships to develop.
Outcome/outputs• Regular recovery group support in the evenings when it is considered people may need the
most support.
• Group help in therapy areas – time off ward.
• Time for people to think about their future and what helps people to get their life on track.
• Opportunity for people to learn from one another.
• Opportunity for people to discuss their hopes and dreams and for support to be given to help people to achieve this.
• Regularly fully attended by people.
• Regular ‘follow up’ input as a result of discussions in group.
• Opportunity for referrals to be made to community services, related to, work employment, voluntary, other social groups. Opportunity for services to come and be part of group to help promote awareness of services.
Key Words Recovery, Group, Occupational Therapy
Contact name and e-mail for more informationEsther Hepple (Impatient Occupational Therapy Team: City Adult Mental Health Services)
ProductivityImproving productivity is not a straightforward
task, sometimes the term is misunderstood. The
concern is that it implies cutting budgets, reducing
services for patients and reducing staff. In fact,
the productive approach is a combination of doing
things right and doing the right things.
Twelve good practice areas were identified from the
Nursing and Allied Health Professionals celebration
event as being excellent examples of productive
working. The coalition Government has called
for productive action at all levels within the NHS
system from Government to frontline teams – the
following are examples of how clinical services in
Nottinghamshire Healthcare are responding:
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Lean Project Development
Development of Therapy Technical (TI) Instructor Role
Triage system for referrals
Outcome measures for service users
Productive Partnership working with Alcohol Treatment Requirements (ATR)
Interface with Acute Trust Providers
Accident & Emergency Liaison with Adult Mental Health Services
Acute Recovery Team Service Adaption
Implementation of General Practice I.T. System
Reflection of Team Productivity
Diagnostic Pathway for Dementia
Productive working between Physiotherapy Team and Day Centre Team to set up multi-activity groups for adults with Learning Disabilities
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Title of Best Practice ExampleStructured triage system for referrals accepted to Child and Adolescent Mental Health Services (CAMHS).
Summary of the Best Practice ExampleReferrals are processed through a triage team to be discussed and booked into available assessment slots based upon risk and clinical need.
Outcome/outputs
Key Words Triage, Young People, Families
Contact name and e-mail for more informationZoe Hoyle (Thorneywood Child and Adolescent Mental Health Services) [email protected]
Standing Nursing & Allied Health Professionals Advisory Council
Title of Best Practice ExampleLean Project Development.
Summary of the Best Practice ExampleAllocation meetings occur daily instead of weekly.
Outcome/outputs• Lean project meeting initially to look at
smarter ways of working and saving time.
• Daily meetings done on a rota system ensuring two clinicians and one medic are present.
• Patients are allocated to relevant clinician or service.
• Patients referrals are seen quickly.
• All referrals go through this process. maximising good clinical governance.
• Outcome and patient details are recorded, so no one ‘slips through the net’.
Key Words Lean Project, MHSOP
Contact name and e-mail for more informationJane Statham (City North Community Mental Health Team: Mental Health Services for Older people) [email protected]
Title of Best Practice ExampleDevelopment of Therapy Technical (TI) Instructor Role.
Summary of the Best Practice ExampleTherapy Technical Instruction works across Occupational Therapy and Physiotherapy which has produced a productive and coherent service for patients in the community. Intervention plans can be worked on as a team saving time and creating continuity.
Outcome/outputs• Suitable training and supervision identified
and given to TI staff with an increase in skills.
• Weekly meetings between therapy staff to ensure joint goals are set and monitored.
• PAD used to set suitable objectives to develop skills.
• More time for qualified staff to complete assessments/develop plans.
• Increased continuity for patients.
Key Words Therapy Technical Instructor
Contact name and e-mail for more informationClare Marriott (Broxtowe Community Mental Health Team: Mental Health Services for Older people) [email protected]
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• Referrals accepted at single point of access meeting.
• Discussed as triage/allocation meeting.
• Level of risk and clinical need influence the decision when the young person will be seen, for example this may be a duty slot or regular triage slot.
• Young people are all seen within 8 weeks for initial assessment.
• The triage system supports an effective decision making process informing who they will be seen by in the multidisciplinary team.
• There is limited waiting and no breaching of this time scale.
• Young people and families are assessed by two practitioners. Issues are brought to a wider Multi Disciplinary Team for discussion.
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Title of Best Practice ExampleSelection of appropriate outcome measures for service users.
Summary of the Best Practice ExampleIdentifying an outcome measure for individual episodes of client care that measures the outcome of trust.
Outcome/outputs• Team has developed understanding about a range of measures that might be appropriate, including
course attendance.
• Formation of a small working party of colleagues to explore and select most appropriate measure.
• Summary of relevant information and creation of own team documentation to use.
• Trial documentation and application to the client group.
• Taught introductory session to the staff team.
• Arranged further in depth training for the staff team.
• Application into day to day practice.
• Planned timescale for the shift team to apply routinely into practice.
• Subsequent benefit to service is to offer opportunity to improve personal effectiveness by increased focus on aims, objectives and health benefits.
Key Words Outcome measures, clinical effectiveness
Contact name and e-mail for more informationPatricia Richardson (Community Physiotherapy Team: Learning Disability Services)
Title of Best Practice ExampleProductive Partnership working with Alcohol Treatment Requirements (ATR).
Summary of the Best Practice ExampleOxford Corner team members work closely between clients and the Probation Service. This improves efficiency, lowering waiting times, less replication of work and effective management of Alcohol Treatment Requirements (ATR).
Outcome/outputs• Faster response to client needs.
• More reliable information sharing and management.
• Reliable response to Court Service needs.
• Client needs assessment turnover well within required timescales.
• Reduces waiting times for clients.
• Reduces duplication of work between agencies.
• Improves information sharing between agencies.
• Looks to reduce offending and assist service user in making necessary changes that courts require to avoid custodial sentence.
Key Words Alcohol Treatment Requirement
Contact name and e-mail for more informationMat LeLouet and Maxine Barrett (Oxford Corner Alcohol Team: Substance Misuse Services)
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Title of Best Practice ExampleInterface with Acute Trust Providers.
Summary of the Best Practice ExampleSite managers at a local acute trust providing services to Rampton Hospital receive training and support about Rampton and the patient group.
Outcome/outputs • Communication links between NHS Trusts.
• Visits to site to support general awareness and understanding.
• Presentation to site managers at acute trust by senior nurses/security staff at Rampton.
• Policy development, care of high secure patients whilst inquiring acute care.
• Faxed discharge letters in line with national standards for GP services.
• First line for complaints.
• Emergency care plans for individual patients if requiring acute hospital care.
Key Words Partnership working with external agencies
Contact name and e-mail for more informationBarbara Pryse (Health Centre: Rampton Hospital) [email protected]
Title of Best Practice ExampleAccident & Emergency Liaison with Adult Mental Health Services.
Summary of the Best Practice ExampleProvision of a liaison service within an A&E department in an isolated geographical area that has cost efficiency, productivity and positive feedback from service users and carers.
Outcome/outputs• Multi disciplinary working between two trusts.
• Focus on service users' needs whilst in crisis.
• Focus on improving access to services at the point of entry.
• Supporting the European Directive to reduce doctors working hours.
• Development of joint improved documentation ensuring that service users do not have to retell their story.
• Reduction of waiting time for secure users in A&E departments who have mental health wards.
Key Words Access, Signposting, Treatment
Contact name and e-mail for more informationSarah Bradshaw (Crisis Resolution Home Treatment Team, County Adult mental Health Services) [email protected]
Title of Best Practice ExampleThe Adaption of Acute Recovery Team to reflect the Acute Care Pathway.
Summary of the Best Practice ExampleA tailored service that meets service user need moving away from a traditional ‘office hours’ model.
Outcome/outputs
Key Words Art, Flexible Working, Groups
Contact name and e-mail for more informationTeresa Ford (Acute Recovery Team, Millbrook: Adult Mental Health Services) [email protected]
• Qualified nurses, occupational therapies, HCAS and activity coordinators plan to operate flexible and “out of hours” shifts.
• Increase in accessibility and flexibility of the service. A team meeting was held and a consultation rota is in progress.
• Pattern of working starts on 6th December and be reviewed after 3 months. Working 7 days a
week between the hours of 7:30am and 9:00pm rather than Monday – Friday.
• During this period, new groups and activities will be piloted.
• This will increase the variety and diversity of the activities and groups we are able to provide and will improve the accessibility to service users who are currently not utilising the service.
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Title of Best Practice ExampleReviewing the Diagnostic Pathway for Dementia.
Summary of the Best Practice ExampleReview and audit of a diagnostic pathway revealed hidden waits for clients and in some instances duplication of assessments.
Audit helped reveal areas for improvement specifically the handling of inappropriate referrals.
Outcome/outputs• Development of joint memory clinic reducing the number of appointments for the individual.
• Reduction of wait time between internal referral to other professionals.
• Multi disciplinary approach to assessments.
• Identify need for community follow up either CPN/OT earlier.
• Triage referrals at first contact.
• Improve efficiency and effectiveness.
Key Words Audit Dementia
Contact name and e-mail for more informationTracey Wilkinson (Woking Age Dementia Service: Mental Health Services for Older People)
Title of Best Practice ExampleImplementation of General Practice I.T. System.
Summary of the Best Practice ExampleAll Rampton Hospital patients are registered onto a system which assists practitioners in treatment and management of chronic diseases and physical healthcare generally.
Outcome/outputs• Staff training in use of system.
• Transfer of patient information on to new system.
• Creation of disease registers.
• Creation of reports recognising national recommendations (NICE & NSF).
• Ability to create effective governance reports.
• Reporting can identify shortfalls in service provided.
• Service then measured against quality outcome framework.
Key Words Physical Healthcare
Name of the Unit/Team Ward that has hosted or led the Best PracticeMarie Harrison (Health Centre, Rampton Hospital) [email protected]
Title of Best Practice ExampleReflection of Team Productivity.
Summary of the Best Practice ExampleThe Community Learning Disability Team compiles monthly records to highlight nursing activity within the team. This includes discussions, decisions and interventions delivered to service users.
Outcome/outputs • Assists with identifying training needs
of nursing staff.
• Identify sources of referral.
• Aids productive planning and allocation of resources.
• A log of work undertaken is used as a source of planning.
• Source of celebration and development.
Key Words Monthly log
Contact name and e-mail for more informationKaren law (City South Community Learning Disability Team: Learning Disability Services)
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Title of Best Practice ExampleProductive working between Physiotherapy Team and Day Centre Team to set up multi-activity groups for adults with Learning Disabilities.
Summary of the Best Practice ExampleMulti-activity group being undertaken at a social services day centre for adults with Learning Disabilities, initiated by the Physiotherapy Team. Individuals’ needs are identified with therapy groups initially led by Physiotherapy Team, then handed over to day centre staff to run.
Outcome/outputs • Individual service users referred to Physiotherapy Team.
• Individual assessment undertaken to identify need.
• Identification of common areas of physiotherapy need.
• Consideration of running multi-activity group to help motivate service users.
• Physiotherapy liaised with Day Centre Management to ensure staff could be released to support group, with the goal of Day Centre staff continuing to run the group, after some initial work.
• Group has run for 12 weeks with Physiotherapist and Physiotherapy Assistant facilitating group with assistance of member of Day Centre staff.
• The following steps are the process for Physiotherapy to put together pack for Day Centre staff member including:
• Relevant physiotherapy goals/ medical info.
• Treatment aims for individuals.
• Suggested components for group sessions.
• Plans of activities used in Physiotherapy led sessions, to act as a resource for Day Centre staff.
• Day Centre Team become proactive in wanting to support group.
• Enthusiasm of Day Centre staff.
• Excellent example of productive working between teams.
• Group has shown good results with the service users being incredibly supportive of each other.
• Group dynamics have been particularly beneficial in encouraging movement in one service user.
Key Words Physio Group Day Centre
Contact name and e-mail for more informationKaren McDonnell (Physiotherapy Team: Learning Disabilities services) [email protected]
Prevention
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Infection Control and Physical Health Link Practitioners
Healthy Living Group
Improving the Physical Health of Service Users on Inpatient Units
Therapeutic Management of Violence and Aggression Training
Primary Health Care and Healthy Lifestyles Group
Patient and Carer Involvement in Infection Control
Health Improvement Profile (HIP)
Reducing Workplace Violence in the Mental Health and National Learning Disability Directorate at Rampton Hospital
Promoting Physical Healthcare at the Peaks Unit at Rampton Hospital
Infection Control Resource File
Health and Wellbeing Programme for Medium Secure Patients
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Prevention is the fourth part of the QIPP agenda.
Prevention covers a range of areas spanning from
safeguarding to staff safety and wellbeing, to
physical healthcare and infection control. A key
challenge for healthcare professionals is to view
Prevention as a valid but also positive and necessary
component of clinical practice.
The following 11 examples have been chosen for
their success in developing innovative preventative
practice that is clearly having a positive impact on
the client group, their carers and the clinical staff
who work with them.
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Title of Best Practice ExampleImproving the Physical Health of Service Users on Inpatient Units.
Summary of the Best Practice ExampleAllocation of a lead physical healthcare nurse on Lister Ward. Focus on working with medical team. Carrying out physical assessments and working with service users to promote good health.
Outcome/outputs• Staff nurse completing physical healthcare assessment with all service users.
• Same nurse trained in taking bloods, ECGs etc so can carry out timely and consistent checks.
• Improvement in identification of physical health complaints and increased uptake of treatments.
• Ward team completing presentations across country (including HIP tool use).
Key Words Physical Healthcare
Contact name and e-mail for more informationAndrea Worrall (Lister Ward: City Adult Mental Health Services) [email protected]
Title of Best Practice ExampleInfection Control and Physical Health Links Practitioners.
Summary of the Best Practice ExampleRegular meetings to discuss the infection control and physical healthcare have created excellent examples of preventative practice.
Outcome/outputs • Regular meetings organised – full days include
training with full evaluation.
• Each clinical area has a representative, currently 30 link practitioners exist in local services.
• Practitioners provides resource files including such information as cleaning sharps, infections, use of personal protective equipment.
• Examples of tried and tested products e.g. vernacare tape cleaning commodes, clirell wipes, disposable gloves.
• Regular contact with clinical areas to offer support e.g. outbreaks, advice, on cleaning, decontaminate.
Key Words Link Infection, Physical
Contact name and e-mail for more informationInfection Prevention and Control/Physical Healthcare Team Local Services/Forensic Services
[email protected] or [email protected]
Title of Best Practice ExampleHealthy Living Group.
Summary of the Best Practice ExampleThe Healthy Living Group was set up to give patients an opportunity to make their own meals using healthier methods. This group was set up to give patients an opportunity to make their own meals that are healthy and work positively towards weight loss.
Outcome/outputs • Patients have developed a level of
independence and opportunity to develop planning skills.
• The programme has given patients the opportunity to eat more healthily.
• Modelling to maintain ideal body weight.
• Patients have time to sit down and discuss as well as plan what they are going to cook.
• Boosts self esteem and improves mental health.
• Tackles obesity.
• Maximises patient choice.
Key Words Healthy Eating, Wellbeing
Contact name and e-mail for more informationFlorence Chikopa (Tamar Ward: Arnold Lodge medium Secure Services)
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Title of Best Practice ExamplePatient and Carer Involvement in Infection Control.
Summary of the Best Practice ExampleInfection prevention and control (IPC) is high on the list of priorities for the Trust with most emphasis on staff education. The Infection Prevention Control Team (IPCT) is now taking steps to include patient education by visiting and being involved in the Patient Council, patient community groups to discuss infection control issues.
Outcome/outputs
Key Words Service User Involvement
Contact name and e-mail for more informationAudrey Kirkland (Infection Prevention and Control Team: Rampton Hospital)
Title of Best Practice ExampleTherapeutic Management of Violence and Aggression (MVA) Training.
Summary of the Best Practice ExampleThe MV&A training team revise incidents of violence and aggression throughout the Trust. This leads to safer patient care, and reduction in injuries. This creates a safer clinical environment for staff and carers.
Outcome/outputs • Delivery of required essential training to the
local services division of the Trust.
• Expert advice given for those who seek it.
• Income generation.
• Working according to NICE guidelines re: curriculum and approach to practice.
Key WordsManagement of Violence, Management of Aggression
Contact name and e-mail for more informationShirley Wright (Therapeutic Management of Violence & Aggression (TMVA) Team)
Title of Best Practice ExamplePrimary Health Care and Healthy Lifestyles Group.
Summary of the Best Practice ExampleLinking mental health and physical healthcare is a duty of care. Staff at Wathwood working within the healthcare department all have dual roles and work on wards within the hospital. This ensures therapeutic relationships with patients and encourages compliance with physical health reviews.
Outcome/outputs • Health review for all patients at admission.
• All patients are seen by a General Practitioner within 72 hours of admission.
• Patients are given availability to all support services.
• Patients are automatically referred to Healthy Lifestyles groups for education on diet.
• Regular follow up health reviews by staff that patients are familiar with.
Key Words Health, Lifestyles
Contact name and e-mail for more informationDenise Carr (Wathwood Hospital)
• IPCT members were asked to attend patients groups to talk about infection prevention and control and hand hygiene.
• Practical hand hygiene training has been carried out in these meetings.
• Follow up requests to attend patient ward meetings to continue this education for those who cannot attend meetings off the ward.
• The team have spoken at Rosewood Involvement Centre and are due to attend Patient Council with other meetings arranged throughout 2011.
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Title of Best Practice ExampleHealth Improvement Profile (HIP).
Summary of the Best Practice ExampleEffective use and implementation of the Health Improvement Profile (HIP).
Outcome/outputs • Creation of a training package to present to
nursing clinical and AHP staff around the HIP including a practical session on basic obs.
• Information on physical healthcare screenings.
• Advice on detection of physical health abnormities.
• Increased knowledge of a wider range of physical health issues.
• Refresher of taking physical obs.
Key WordsHealthcare Improvement Profile
Contact name and e-mail for more informationLaura Hodgson (Physical Health and infection control and prevention team, Local Services)
Title of Best Practice ExampleReducing Workplace Violence in the Mental Health and National Learning Disability Directorate at Rampton Hospital.
Summary of the Best Practice ExampleThe development of a team to review and analyse workplace violence using a root cause analysis process and to develop action plans to minimise future occurrences through a lessons learning communication system.
Outcome/outputs • Setting up group (terms of reference and
group membership).
• Data/information gathering.
• Agreeing outcomes (risk assessment changes in practice training).
• Action on outcomes and communication to clinical staff.
Key WordsWork Place Violence, Route Cause Analysis
Contact name and e-mail for more informationDave Jones (Mental Health and National Learning Disabilities Services: Rampton Hospital)
Title of Best Practice ExamplePromoting Physical Healthcare at the Peaks Unit at Rampton Hospital.
Summary of the Best Practice ExampleWork with the Peaks Unit highlights physical problems/issues with a patient group that are seen to be difficult to engage. Work has raised awareness and identified previously unknown physical healthcare needs.
Outcome/outputs• General Physical Healthcare awareness.
• Hand washing teaching file for staff and patients.
• Raising awareness of salt and caffeine intake.
• Deltoid injection training.
• Weight management, communication and discussions.
Key Words Health Promotion
Contact name and e-mail for more informationMargaret Kirk (Peaks Unit: Rampton Hospital) [email protected]
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Title of Best Practice ExampleInfection Control Resource File.
Summary of the Best Practice ExampleSenior nursing staff identified in 2009 that there was a deficit in infection control information available for ward based and therapy services and staff and that this could be a contributing to a lower standard of cleanliness and PEAT/external audit scores the hospital was hoping to receive. An infection control resource fire was subsequently developed.
Outcome/outputs • Junior Matrons take responsibility for developing the file on taking the lead clinically and the
other liaising with Hotel Forensic Services wide to develop the standards required in respect of cleanliness standards.
• File includes all information required for staff to manage infection control outbreaks.
• File included all cleanliness standards/tasks to be undertaken with sign of sheets includes.
• File is an important resource for all staff, including all information relating to what to do in the event of needle stick injuries, spillages and with contact details/numbers provided as appropriate.
• Since the implementation of the file cleanliness standards have substantially improved and staff. feedback is excellent. Staff value the file as a product and refer to it on a regular basis as a guide.
Key Words Infection control
Contact name and e-mail for more informationCharlotte weaver (Arnold Lodge medium Secure Unit) [email protected]
Title of Best Practice ExampleHealth and Wellbeing Programme for Medium Secure Patients.
Summary of the Best Practice ExampleThe Health and Wellbeing programme enables patients to make healthier choices and learn how to manage their weight effectively.
Outcome/outputs • A 12 week programme, facilitated by Primary Health Care, Sports and Leisure and Psychology.
• Provision of education, useful practical tools and resources combined with behaviour therapy.
• Physical and mental health collaborative approach.
• Support of a 20 minutes activity taster on how physical activity can be fun and form part of every day life.
• Healthy eating and increased physical activity.
• Support and mentorship driving the programme and continued after the completion of the programme.
• Goals are to reduce Body Mass Index, cholesterol levels, improve fitness levels.
• Positive and healthy choices in eating and physical activity.
• Healthy behaviour change.
• Promising autonomy and independence.
Key Words Obesity, Wellbeing, Recovery
Contact name and e-mail for more informationNichola Mistry (Primary Healthcare: Arnold Lodge)
To obtain more copies of this document or to find out more about the SNAAC please contact Julian Eve on 0115 969 1300 ext 10681.
Designed and produced by Red Riot Design | 01623 645 147 | August 2011
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