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The Triangle of Care Carers Included: A Guide to Good Practice in Mental Health Care

The Triangle of Care Carers Included: A Guide to Good Practice in Mental Health Care. Ruth Hannan, Policy & Development Manager. Carers Trust – Who are we?.

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The Triangle of Care Carers Included: A Guide to Good Practice in Mental Health Care

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  1. The Triangle of Care Carers Included: A Guide to Good Practice inMental Health Care Ruth Hannan, Policy & Development Manager

  2. Carers Trust – Who are we? • Carers Trust is a major new charity for, with and about carers, combining the knowledge, skills, expertise and experience of its founder charities –The Princess Royal Trust for Carers and Crossroads Care – and all of its Network Partners. • • Carers Trust has been operational since 1 April 2012. • • The Princess Royal Trust for Carers was founded in 1991. • • The first Crossroads Care pilot project was set up in 1974. • • Carers Trust is the largest provider of comprehensive support services, reaching more than 398,000 carers, including more than 24,500 young carers, through a unique network of 124 independently managed carers’ centres, 73 schemes, 107 young carers services and interactive websites. • • Carers Trust manages seven different websites for different target audiences plus a policy blog. • • In many locations, Network Partners support young carers. Young carers are children and young people who often take on practical and/or emotional caring • responsibilities that would normally be expected of an adult.

  3. “The Carer’s needs are as great as the patient’s needs.” (Hospice Movement) • “They didn’t know who I was, they told me nothing and I wasn’t expecting him when he was sent home.” (Carer) • “Why involve the carer? They are already involved – and are likely to continue to be involved after the professional has moved on.” (Consultant Psychiatrist)

  4. A Disconnected Model of Involvement • Can Lead to… • Carers being excluded at certain points of the care pathway • Failure to share information on risk assessment and care planning • Requests by carers for information, support and advice not heard • Carers unique and expert views on the service user can be missed

  5. It’s a simple solution…..

  6. The Triangle of Care Project in England • Guide developed by a carer (Alan Worthington) over a number of years. • Guide launched in final format in July 2010 at the House of Commons. Partnership project between The Princess Royal Trust for Carers (PRTC) & the National Mental Health Development Unit (NMHDU) • NMHDU closes March 2011 • PRTC take lead on initiative setting up a national Triangle of Care Steering Group • Write to all mental health trusts in England (58 in total) – one quarter reply.

  7. National Project • Carers Trust awarded funding as part of Department of Health’s Innovation Programme • Establish National Steering Group made up of Carers Trust Network Partners, Mental Health Trusts, National Charities, Representatives of RCN and RCPsych and Carers. • Hold a series of Regional Events • Establish Regional Groups – 48 Mental Health Trusts involved and over 30 local carers organisations.

  8. Project Outcomes • Produce quarterly Triangle of Care good practice newsletter • Develop three leaflets promoting the benefits of the Triangle of Care • Hold regional events and develop regional groups • Research good practice mental health respite models • Gather good practice examples to be collated on the Virtual Ward • Develop a Triangle of Care “Kitemark” – more later • Evaluate the Triangle of Care Model

  9. The Principles of the Triangle of Care • Carers and the essential role they play are identified at first contact or as soon as possible thereafter • Staff are “carer aware” and trained in carer engagement strategies • Policy and protocols re; confidentiality and sharing information are in place • Defined post(s) responsible for carers are in place • A carer introduction to the service and staff is available, with a relevant range of information across the acute care pathway • A range of carer support services is available • And regular assessing and auditing to ensure these six key elements of carer engagement exist and remain in place.

  10. Why Do We Need It? • Aim of Service User? To Get Well • Aim of Carer? To Support Loved One to Get Well • Aim of Professional? To Support Patient/Client to Get Well

  11. The Benefits for Carers of the Triangle of Care • Recognition for the carer. • • An appreciation of the carer’s unique knowledge about the person they • care for. • • Information being provided about the person they care for including their illness, medication and prognosis. • • Emotional and practical support – enabling carers to have a life of • their own alongside their caring role. • • Assistance with care planning and knowing who to contact in a • crisis or emergency. • • Helping carers to feel part of a team and less isolated. • • Helping carers feel stronger, more resilient and better able to cope • with caring.

  12. Benefits for Service Users of the Triangle of Care • Comprehensive care and support from home to ward. • A more personal service, where a service user’s views and feelings are respected and implemented. • Reducing the need to repeat information again and again. • A more stable and calmer home environment where a service user and their family feel less stressed. • Less need for a service user to act as a ‘go between’ between mental health staff and carers.

  13. Benefits for Staff of the Triangle of Care • Creating a more helpful, supportive relationship with carers. • Giving carers and service users realistic expectations. • Ensuring staff have information about service users’ moods, behaviours and the best way to interact with them. • Getting more support from carers on the ward. • Partnership working – if the service user exhibits challenging behaviour, the carer may be able to influence their behaviour. • Reduced admissions – a carer can often recognise the signs that a service user is becoming unwell. By listening to carers, steps can be taken to help reduce the need for a service user to be admitted.

  14. Local Implementation – Feedback • South West London & St George’s Mental Health Trust • Covers 5 boroughs & 5 carer organisations – all working on TOC but in different ways. All have reported successes: • Carers involved in promoting TOC • Increased identification of carers and referrals to carers services • Trust-wide protocol of all carers to be invited to a meeting within two weeks of patient admission • Carers survey introduced via real-time feedback • Carers accessing Recovery College courses • Reduction in complaints and increase in compliments • Positive outcomes for carer wellbeing

  15. Next Steps for Evaluation and Research • Stanbridge, R. (2012), “Including families and carers: an evaluation of the family liaison service on inpatient psychiatric wards in Somerset, UK”, Mental Health Review Journal, Vol. 17 No. 2, pp. 70-80. • Schizophrenia Commission, (Rethink Mental Illness, 2013) – recommendation • Needs: • Impact of Triangle of Care on carers, service users and professionals • Outcomes for professionals, carers and service users • Evaluation of the project

  16. Ruth Hannan Email:rhannan@carers.org

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