cardiff and vale nhs trust ymddiriedolaeth gig caerdydd a’r fro the south cardiff and vale crisis...
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Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
The South Cardiff and Vale
Crisis Resolution
AndHome
Treatment Team Jayne BellTeam Leader029 20 906222
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
Pendine
Hafan Dawel
Amy EvansAmy Evans
Gabalfa
Pentwyn
Links
Barry
Splott
Cardiff Bay
Ely
Penarth
CRHT South
HAMADRYAD
CRHT North
LavernockPoint
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
Where we are
• Based in the Hamadryad Centre, co-located with the South West CMHT
• Approximately geographically central to our sector (traffic allowing!)
• Cover from Llantwit Major to the west, to Llanrumney to the east
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
Who we are
We are a multi-disciplinary team of• 2 psychiatrists• One part time psychologist• One senior social worker• Ten community psychiatric nurses• Five community support workers• One team leader
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
What we do• Offer a genuine alternative to
hospital admission through the provision of home treatment.
• Including the core functions of: Providing a rapid response Acting as the gatekeeper to
hospital beds Providing a prominent role in
facilitating early discharge
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
GP/HV/OTHERAGENCY
CMHT initiatesThe referral
POLICEClient assessed by
Police Surgeon Prior to referral to
CRHTT
POISONS UNITClient assessed by
Liaison Nurse
CARER REFERRALONLY if identifiedAs part of current
Care plan and agreedWith CRHTT A&E
Client assessed byMH Triage NurseAnd CRHTT Staff
Grade Psychiatrist
GENERAL IN-PATIENTWARD
Client must be assessedBy Psychiatrist prior
To referral to CRHTT
DAY HOSPITALMust be seen by Care CoordinatorRMO or other day Hospital staff the
Same day
SELF REFERRALONLY if identifiedAs part of current
Care plan and Previously agreed
With CRHTT
LIAISON PSYCHIATRYClient must be
Assessed by careCo-ordinator/RMO/Liaison
Psychiatry Staff
CMHT (Known Client)Must be seen by care
Coordinator/RMOOther CMHT staff
the same day
MH IN-PATIENT UNITCRHTT will assess for leave/early discharge
CRHTTASSESSMENT
In Hours Referrals
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
SELF REFERRALONLY if previously identified
As part of current carePlan with CRHTT
EMERGENCY DUTY TEAMJoint assessment with
CRHTT
POLICEMust be assessed by the
POLICE SURGEONPrior to referral to
CRHTT MH IN-PATIENT UNITCRHTT will assess prior
To leave or earlydischarge
A&E/POISONS UNITMust have a medicalAssessment prior to
Referral to CRHTT
CARER REFERRALONLY if previouslyidentified as part Of current care
Plan with CRHTT
WEEKEND CPNAssessed by
Weekend CPN orJoint assessment
With CRHTT
GPMust have assessed
a client prior to referral
to CRHTT
CRHTTASSESSMENT
Out of HoursReferrals
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
South CRHT Assessments for Admission Avoidance Oct 06 – Sept 07
CRHTIN PTSMHARTN
CRHT SUPPORT
IN PATIENT ADMISSION
MHA ADMISSION
RETURN TO REFERRER
284 165 78 324
Total No. of assessments 851
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
Why we do it
• Evidence and support for the impact that CRHT services are having
• Beneficial for service users and carers, and the service as a whole
• Service users and carers generally prefer home-based treatment
• CRHT services are as effective both clinically and socially as inpatient care.
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
How we do it• Open 24 hours a day, 7 days a week• Minimum of 4 staff on a day shift,
one at night. 3 shifts within 24 hours• Provide intensive contact for up to 6
weeks• Support people in the least
restrictive environment as close to home as possible
• Offer early discharge support for those who need a stay in hospital
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
CRISIS HOUSE
Philosophy:- • Short-term accommodation for adult
clients with severe and enduring mental illness who are experiencing acute mental health crisis
• Avoid stigmatisation of hospital admission
• Safe, comfortable and supportive environment
• Staffed 24 hours by support workers, supported by the CRHTs
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
Crisis House cont’dService aims:- • least restrictive environment with
the minimum of disruption to their lives.
• The Crisis House will only be accessed via the CRHTT who will act as “Gatekeeper” to the service.
• Provide intensive support to clients in the Crisis House as an alternative to inpatient care.
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
Crisis House cont’d
• To provide practical and emotional support to individuals who are experiencing an acute psychiatric crisis.
• Be actively involved in “care planning” to facilitate a return to the individuals home.
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
CRISIS RECOVERY UNIT
Philosophy:- • assessment, therapeutic intervention and
support, in a safe environment• provide a flexible and responsive
assessment and treatment service. • The service supports clients of both South
and North Cardiff Crisis Resolution Teams, providing a more intensive and consistent therapy that may not be available in a community based setting.
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
CRU cont’d
• The service provides respite for both Service Users and Carers, reducing tension and de-escalating difficult social situations.
• In some circumstances it will enable carers to return to work, if necessary.
• 7 day service.
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
CRU cont’dService Aims:-
• A range of treatments and activities provided
• Service Users will collaborate in the development of individually designed treatment programmes. These programmes will provide balance of therapeutic interventions, recreational activities and “time out” in a non-pressurised setting.
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
Sector alignment for Admission Avoidance
Assessments
0
50
100
150
200
250 NEW TOSERVICELINKS
HAMADRYAD
AMY EVANS
HAFAN DAWEL
CAU
212
243
174
103 60
7
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
Client Feedback
“ I liked that someone cared enough to listen to my feelings and problems. The staff appeared to show their concerns at my situation, and I felt their advice was specific to me and not necessarily the stock answer.”
“ I would have preferred to have seen the same person on each occasion rather than many different people.”
“ I have learned to monitor my state of mental health by looking out for ‘relapse indicators’, monitoring sleep patterns and social interaction patterns with my family and friends.”
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
Carer Feedback
“It enabled us to support our son at home as we felt assured we could phone if his condition worsened.”
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
References• The Department of Health The NSF
for Mental Health – five years on. London: DOH; 2004
• Northern Centre for Mental Health More than the sum of all parts. Improving the whole system with crisis resolution and home treatment Durham: The Northern Centre for Mental Health; 2003
Cardiff and Vale NHS TrustYmddiriedolaeth GIG Caerdydd a’r Fro
References• Department of Health The Mental
Health Policy Implementation Guide London: DOH; 2001
• Sainsbury Centre for Mental Health Crisis Resolution London: The Sainsbury Centre for Mental Health 2001
• Welsh Assembly Government Policy Implementation Guidance on the Implementation of CRHT in Wales 2005
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