Collaborative Safety Planning

Transcription

1 Collaborative Safety Planning Changing conversations about risk Mrs Jacqui Learoyd: Speech and Language Therapist (Ellesmere House and Community LD Team Shropshire)

2 Good practice in risk assessment The Department of Health Best Practice in Managing Risk Guidelines (2007). Recovery approaches emphasize that risk management should be built on the recognition of strengths and should emphasize recovery.

3 Commissioning for Quality Improvements Forensic Services - Collaborative Risk Assessments The provision of an active engagement programme to involve all secure service users in a process of collaborative risk assessment and management.

4 Service context Ellesmere House 12 bed low secure service for males with Intellectual Disabilities Clee 32 bed low secure service for males The Hatherton Centre 47 bed medium secure service for males Similarities in cognitive functioning and communication needs across the service

5 Education and training for staff and service users Ensure a robust clinical process Training and supervision Flexible protocol Resources to enhance communication and engagement Assessment of strengths

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7 Tools to support collaborative safety planning Work books on understanding risk assessment Using communication strategies for all service users Easy read HCR-20 s Talking Mats START (which we have adapted for service users) Mind Maps Easy read safety plans

8 Talking Mat using Widgit symbols Widgit symbols from

9 Easy read HCR20 Widgit symbols from

10 Risk mind maps Widgit symbols from

11 Protective factors cards Widgit symbols from

12 Short Term Assessment of Risk and Treatability (START) Standard START tools manual and score sheet Developed in house Talking Mat resources Developed in house START booklet Widgit symbols from

13 Outcomes

14 Staff training 91% of staff reported that the training was relevant to their work 97% of staff were satisfied with the training Majority of staff reported not being confident with undertaking this work before the training 80% reported increased confidence after the training

15 Staff training Loved the training, very useful and feel very enthused to use it Very helpful, look forward to completing it with patients

16 Client reported involvement in safety planning did not know or did not want to know anything about their safety management plans team wrote their safety management plans without them or wrote their safety management plans and discussed it with them actively involved in discussing or writing their safety management plan 52% 31% 37% 33% 30% 17% Quarter 1 Quarter 4

17 Client reported involvement in assessing own strengths did not know or did not want to know anything about assessment of their strengths team assessed their strengths or assessed their strengths and discussed it with them actively involved in discussing or assessing their strengths 47% 44% 26% 30% 31% 22% Quarter 1 Quarter 4

18 Client reported satisfaction with help given to develop safety plan Unsure 6% Unhappy or very unhappy 22% Happy or very happy 72%

19 Client reported satisfaction with their safety plans Unsure 3% Unhappy or very unhappy 19% Happy or very happy 78%

20 Service users perspective on their risks Widgit symbols from

21 Qualitative report of collaborative safety planning process Service user male, medium secure, mental health diagnosis Unlikely to engage with any sessions previously / reputation for non-engagement and being hard to reach Followed protocol with psychology assistant Engaged well with the tasks on the protocol motivated, working for 45 to 60 minutes, able to participate and complete work

22 What his safety plan looks like

23 Examples of safety plans Formulation diagrams

24 Safety plans

25 Safety plans

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27 Feedback on the protocol in forensic LD setting The protocol was written for the whole forensic directorate. It had levels of detail that allowed a choice of task. On the low secure forensic LD setting, the staff following the protocol found the choice of task confusing. They have asked for the protocol to be simplified for forensic LD and made more prescriptive. This will be trialled for new admissions over 2016 and feedback sought.

28 What next? Embedding collaborative safety planning Safety plans as working documents Barriers to engagement Review of protocol

29 Contact Mrs Jacqui Learoyd Ellesmere House St Georges Hospital Corporation Street Stafford ST16 3AG