A carer s guide to mental health services

A carer s guide to mental health services

Welcome to North East London NHS Foundation Trust (NELFT) We are committed to working in partnership with carers. All our staff are aware of and acknowledge the signiicant contribution you make to the life of the person you care for. We have produced this booklet to provide you with information about our mental health services and to answer some of the questions you may have. We hope you ind it useful. Contents Who is a carer? 4 Carers needs and rights 4 Assessment and care planning 4 Care Programme Approach (CPA) 5 Admission to hospital 6 The Mental Health Act 6 What may the person I care for need when they are an inpatient in hospital? 6 Smoking 7 What is not allowed on the wards? 7 Visiting the ward 8 2

What happens to the person I care for during their stay? 8 Medication and treatment 8 How long will the person I care for stay in hospital? 9 What happens when they show signs of improvement? 9 Going on leave 9 What happens when the person I care for is ready to be discharged? 9 Carers support groups 10 Conidentiality and consent to share information 10 Data Protection Act 10 Who can I talk to? 11 Compliments, concerns and complaints 11 Glossary 12 Financial support 13 Local carer support groups 14 Other useful websites and contact information 15 3

Who is a carer? Many carers say they are not a carer, they are a mother, son, sibling, friend or other family member, doing what anyone else would do. Caring for someone includes giving them emotional support and encouragement, as well as practical and physical help. Getting some support will help you and, in turn, the person you care for. Carer is a government term used through legislation and guidance, so health and social services are required to use the term carer in certain situations. When we use this term we are usually talking about close relatives or friends supporting the service user. A carer does not have to live with or even live near the person they care for to provide emotional and psychological support. Carers needs and rights A person who provides regular and substantial care to a person with a mental health problem is entitled to an assessment of their needs as a carer. It is your opportunity to say what would help you in your caring role, and to ind out what services are available that may support and assist you in continuing to care. This is known as a carers assessment and should be offered to you by a member of staff. Once an assessment has been carried out you will receive a written copy of it, and of any care plan that is produced, as part of the assessment. You have the right to request a carers assessment at any time. Assessment and care planning All service users will have an individual assessment and a care plan that will take account of their current needs. 4

Care Programme Approach (CPA) You may hear the term CPA. This stands for Care Programme Approach and applies to people who have more complex needs. This is decided by the care team. An assessment of the health and social needs of the service user is carried out. A plan is then written up outlining any needs and what action will be taken to meet them. This will be agreed by the service user and all those involved in delivering care, such as: the GP the mental health team carers, family or friends A key worker (care coordinator) is allocated to keep in regular contact and monitor the progress of the actions in the care plan. A regular review (at least six monthly) of the care plan will take place by way of meetings with the service user and all other persons involved in the plan. If the person you care for agrees, you may be invited to be involved in planning and monitoring the service user s care plan, including attending review meetings. You should speak to the person you care for about this. It is possible that before becoming unwell the person you care for may have completed an advance directive. This enables a competent adult to specify that they do not want certain treatments in the future, in the event of becoming unwell and being unable to decide for themselves. An advance directive should be written with advice from doctors and other professionals, and signed, dated and witnessed. Doctors adhere to a valid advance directive, although it can be overridden by the powers of the Mental Health Act. 5

In the majority of circumstances most people can be cared for at home, but there still may be situations where hospital admission is needed. The following section provides information about this. Admission to hospital On admission to hospital the person you care for will undergo a period of assessment. During this time they will be asked to remain on the ward for observational purposes and to initiate treatment. The type of admission is either informal (agreeing to care) or formal (sectioned under Mental Health Act 2007). The length of stay on a ward varies for each individual. However, the aim is to ensure the person you care for is well enough to go home as soon as possible. We realise that having your relative or friend admitted to hospital can be very stressful and, in the initial days, you may have many questions. Please discuss any questions or concerns with a member of staff. The Mental Health Act Some patients are detained in hospital under the Mental Health Act. The main purpose of the Mental Health Act 2007 is to allow compulsory action to be taken, where necessary, to make sure that people with mental disorders get the care and treatment that they need, for their own health or safety or for the protection of other people. It sets out the criteria that must be met before compulsory measures can be taken, along with protections and safeguards for patients. What may the person I care for need when they are in hospital? A person staying in an inpatient ward will need a 6

change of day clothing, night wear, and basic toiletries. Mobile telephones and chargers are allowed on some wards. The ward staff will be able to inform you further. Small change may be required for the use of a public telephone or to purchase items from the shop. A washing machine may be available, so either soap powder or money to purchase some from the shop may be required. Alternatively you may wish to take their laundry home. Details of any medication currently being taken should be kept by the person you care for. It may help to give a copy of this to the ward staff. The use of razors will need to be discussed with a member of staff. Staff will make a record of what has been brought in. Valuable items are best left at home. Smoking Designated smoking areas are available for inpatients and there will be details about this on the ward. North East London NHS Foundation Trust (NELFT) operates a no smoking policy and it is forbidden for visitors to smoke on any NELFT premises. What is not allowed on the wards? Electrical equipment, such as hair dryers and radios, are not allowed to be brought into the ward. Hair dryers are available on the wards. Sharp objects, such as razors, and objects that can cause harm, such as scarves, belts and cigarette lighters, are also prohibited. Illegal substances and alcohol are prohibited on all Trust premises. 7

North East London NHS Foundation Trust cannot accept responsibility for the loss of or damage to personal property of any kind (including money), in whatever way it occurs, except for property handed in to the Trust for safe keeping and for which an oficial receipt is obtained. Visiting the ward Visiting times vary from ward to ward and are displayed by the entrance to the ward. Alternatively, you can ask a member of staff. Patient protected time is time allocated for the staff and the person you care for to be able to interact on a one to one basis. This includes meal times. At these times visitors are not encouraged. Family rooms are available for visits. Please speak to a member of staff who will be happy to arrange this. Due to limited space on the ward we advise only two or three visitors per person at any time. What happens to the person I care for during their stay on the ward? On admission the person you care for will be under observation and may not be allowed to leave the ward. They will be asked if there are any individual requirements, for example, dietary, spiritual or disability needs. Medication and treatment Information on medication and side effects can be obtained from the ward staff, in lealets, or on the Choice and Medication website: www.choiceandmedication. org/nelft/ Medication and treatment will depend on the nature of the illness. 8

How long will they stay in hospital? Recovery times vary depending on the severity of the illness. However, the ward team will be able to keep you updated on progress. What happens when they show signs of improvement? If the person you care for is on a psychiatric intensive care unit, they will be transferred to an acute ward to continue treatment. On an acute ward the person you care for will, as part of their treatment and recovery, be encouraged to spend time away from the ward environment. This varies from a short time away locally to an overnight stay at home, depending on the person s progress. Going on leave If you have any concerns when the person you care for is on leave, you should contact the ward who will be able to advise you further. The ward staff may request the person you care for returns to the ward. In the event of refusal to return to the ward, the ward team will make arrangements for a member of staff to visit and carry out an assessment. What happens when the person I care for is ready to be discharged? When the person you care for has shown signs of recovery, you as a carer may be invited to a review meeting to discuss progress and further planning. This will be aimed at working towards discharge from hospital to home. 9

Possible follow-up after discharge may involve the home treatment team, outpatient appointments, and the community recovery team who may have been involved prior to admission. Carers support groups Wards and community recovery teams may offer a carers support group. These are facilitated by a member of staff from the ward or team and offer the opportunity for carers to share experiences and gain further information. Conidentiality and consent to share information If the person you care for does not wish the ward team to share information with you about their care and treatment, information may be limited to safeguard conidentiality. However we still want to hear your views and any information about the service user you think is important. Staff will talk to you about your information and who it is shared with. You will be required to give consent to us sharing any information. We will only share information with any other statutory organisations, for example, GPs and social workers, unless we have concerns. All service user and carer information is kept on a secure electronic records system known as RiO. For more information please refer to the lealet NELFT, your information and how it is used. This lealet can be obtained from staff or by visiting www.nelft.nhs.uk Data Protection Act All information is protected and processed in accordance with the Data Protection Act 1998. 10

Who can I talk to? The team on the ward will be able to discuss any worries you may have and listen to your concerns. The ward team will also be happy to give you the ward telephone number. Chaplains regularly visit the wards, and there is a multi-faith prayer room. Compliments, concerns and complaints NELFT wants to make sure you receive the highest quality service possible. We welcome your feedback and involvement. Your comments, compliments and concerns will help us to learn and improve our services. We listen carefully and do everything possible to ensure your comments and concerns are addressed. If you do have a concern, please speak to the staff or service manager in the irst instance. Speaking directly to the people providing services is often the best way of resolving any problems. On receipt of a written complaint, an acknowledgement letter will be sent to you along with further information regarding the complaints process. You will be informed about the progress of your complaint at every stage. Written complaints should be sent to: Complaints oficer Quality and patient safety North East London NHS Foundation Trust Admin block St George s Hospital Suttons Lane Hornchurch Essex RM12 6RS All compliments received will be shared with the team involved. Our staff appreciate hearing when things have gone well. 11

Glossary Assessment This means inding out what help a person needs. Many areas are covered in the assessment - not just with regard to mental wellbeing, but other areas, such as housing, employment, beneits and family situation. Care programme approach (CPA) A government requirement that health and social services work together with the mental health service user to provide an agreed programme of care. Care coordinator A qualiied mental health professional who coordinates resources to meet the needs identiied in the care plan. They work closely with other health professionals involved in the care of the service user. Carers assessment A person who provides regular and substantial care to a person with a mental health problem is entitled to an assessment of their needs as a carer. Care plan A document written once an assessment of the person s needs has been completed. The document is agreed between the service user, relatives and/ or carers (if appropriate), and the relevant health and social services. It gives clear guidance on how to help the person remain healthy. Community psychiatric nurse (CPN) A qualiied nurse who has received specialist training working with people who have mental health problems. Community recovery team (CRT) A team of specialist workers with health and/or social care training who offer support in the community. 12

Occupational therapist (OT) A worker who has professional training to help and support people to develop conidence and skills in daily living and practical tasks. Psychiatrist A medically trained doctor who has specialised in mental health. They are responsible for the diagnosis and care of patients, including the prescribing of medication. They also have further responsibilities and duties implementing the Mental Health Act. Psychologist A specialist worker who can offer a range of psychological treatments, including counselling, cognitive therapy and behaviour therapy. Admiral nurse Admiral nurses provide specialist nursing services to carers of people with dementia. Mental health social worker (SW) A person who has a qualiication in social work and specialises in mental health. Financial support As a carer, depending on your individual circumstances, you may be entitled to certain beneits, listed below. Carers allowance This is the main beneit for carers that are caring a minimum of 35 hours a week. This is subject to certain conditions. Carer premium/addition The carer premium is an extra payment that could increase other beneits, like income support, income related employment and support allowance, housing beneit and council tax beneit. Income support This is extra money to help carers on a low income. 13

Pension credit This is a beneit for people who are of, or over, the qualifying pension age and on a low income. Employment and support allowance (ESA) This is for people whose ability to work is limited by ill health or disability. Tax credits Child tax credit and working tax credit are paid to top up workers/families on a low income. For further information and advice regarding beneits, visit: www.direct.gov.uk/disability The Beneit Enquiry Line 0800 882 200 Carers UK Advice Line 0808 808 7777 Citizens Advice Bureau 08444 111 444 Local carer support groups: Carers of Barking and Dagenham 15 Althorne Way Dagenham Essex RM10 7AY 0208 593 4422 Havering Mind Carers Support Harrow Lodge House Harrow Lodge Park Hornchurch Road Essex RM11 1JU 01708 457040 Redbridge Carers Support Service 3rd Floor 17 Station Road Ilford Essex IG1 4DW 0208 514 6251 Waltham Forest Carers Association St. Andrew s Centre St. Andrew s Road Walthamstow London E17 6AR 0208 531 9652 14

Other useful websites and contact information The Princess Royal Trust for Carers www.carers.org.uk 0844 800 4361 Carers UK www.carersuk.org 0808 808 7777 Crossroads - Caring for Carers www.crossroads.org.uk 0845 450 0350 Age Concern www.ageconcern.org.uk 0800 169 6565 Alzheimer s Society www.alzheimers.org.uk 0845 300 0336 Rethink Carers www.rethink.org/carers 0845 456 0455 MIND National www.mind.org.uk 0845 766 0163 SANE www.sane.org.uk 0845 767 8000 National Carers Direct www.nhs.uk/carersdirect 0808 802 0202 Patient UK www.patient.co.uk Kiloran Trust www.kilorantrust.org.uk 0207 602 7404 Young Carers Net www.youngcarers.net 0844 800 4361 The Children s Society www.childrenssociety.org. uk/youngcarer 01962 711511 The Mental Health Foundation www.mentalhealth.org.uk 15

How can I get more copies of this booklet? If you would like further copies of this booklet, please email storekeeper@nelft.nhs.uk If you would like this information in Braille, large type, in another format or in another language, please ask a member staff. Production date: November 2012 Review date: November 2014 Ref: 201211.92